Hammer toe: Difference between revisions

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List of terms related to Hammer toe

	Hammer toe;
	A Mallet Toe is evident on the 3rd digit
ICD-10	M20.4, Q66.8
ICD-9	735.4, 755.66
MeSH	D037801

← Older edit

VisualWikitext

Latest revision as of 20:57, 19 August 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Sara Mohsin, M.D.[2], Cafer Zorkun, M.D., Ph.D. [3]

Synonyms and keywords: Claw toe; hammertoe syndrome; mallet toe

Overview

A hammer toe is a deformity of the second, third, or fourth toe causing it to be permanently bent at the proximal interphalangeal joint, resembling a hammer. Mallet toe is another name for this condition when affecting the distal interphalangeal joint.

Pathophysiology

Hammer toe occurs due to abnormal (permanent) bend at the proximal interphalangeal joint of a toe due to imbalance in the muscles, ligaments, or tendons which normally hold the toe in a straight position

Risk factors

Common risk factors include:

Advancing age
Female sex
Length of the second toe greater than the big toe
Osteoarthritis
Rheumatoid arthritis
Diabetes

Complications

Few complications of hammer toe include:

Permanent bent of the toe if not treated initially when toe is flexible
Painful corns or calluses due to rubbing of toes against the inside of foot

Causes

Common causes of muscle, nerve, or joint damage resulting in a hammer toe include:^[1]^[2]

Wearing poorly-fit shoes that can force the toe against their tip, such as:
- Excessively high heels
- Shoes that are too short or narrow for the foot
- Osteoarthritis
- Rheumatoid arthritis
- Stroke
- Charcot-Marie-Tooth disease
- Diabetes

History and symptoms

Hammer toe usually involves the second, third, or fourth toe
Common symptoms include:
- Abnormal bend in the joint of one or more toes resembling a hammer
- Painful or difficult movement of the affected toe
- Painful calluses & corns may form (due to rubbing of hammer toes against the inside of the shoes)

Treatment

Conservative treatment

In many cases, conservative treatment is enough to resolve the condition such as:
- Physical therapy
- New shoes with soft, spacious toe boxes

Surgery

In more severe or longstanding cases, orthopedic surgery may be necessary to correct the deformity^[3]^[4]^[5]^[6]^[7]^[8]^[9]

Prevention

Primary preventive measures for hammer toe include:

Buying the shoes with following characteristics:
- Proper fitting
- Low heels
- Adequate toe room (avoiding shoes with pointed toes)
- More roomier and adjustable (laced or strapped shoes)

References

↑ Ridley LJ, Han J, Ridley WE, Xiang H (2018). "Claw toe". J Med Imaging Radiat Oncol. 62 Suppl 1: 126. doi:10.1111/1754-9485.07_12786. PMID 30309185.
↑ Ceccarini P, Rinonapoli G, Sebastiani E, Bisaccia M, Ceccarini A, Caraffa A (2019). "Clinical Comparison Between Shortening Osteotomy of the Proximal Phalanx Neck and Arthrodesis in Hammer Toe Surgery at Mid-TermFollow-Up". J Foot Ankle Surg. 58 (2): 221–225. doi:10.1053/j.jfas.2018.08.002. PMID 30553747.
↑ Doty JF, Fogleman JA (2018). "Treatment of Rigid Hammer-Toe Deformity: Permanent Versus Removable Implant Selection". Foot Ankle Clin. 23 (1): 91–101. doi:10.1016/j.fcl.2017.09.007. PMID 29362037.
↑ Mueller CM, Boden SA, Boden AL, Maidman SD, Cutler A, Mignemi D; et al. (2018). "Complication Rates and Short-Term Outcomes After Operative Hammertoe Correction in Older Patients". Foot Ankle Int. 39 (6): 681–688. doi:10.1177/1071100718755472. PMID 29444584.
↑ Ceccarini P, Ceccarini A, Rinonapoli G, Caraffa A (2015). "Correction of Hammer Toe Deformity of Lateral Toes With Subtraction Osteotomy of the Proximal Phalanx Neck". J Foot Ankle Surg. 54 (4): 601–6. doi:10.1053/j.jfas.2014.11.013. PMID 25746765.
↑ Basile A, Albo F, Via AG (2015). "Intramedullary Fixation System for the Treatment of Hammertoe Deformity". J Foot Ankle Surg. 54 (5): 910–6. doi:10.1053/j.jfas.2015.04.004. PMID 26028601.
↑ Catena F, Doty JF, Jastifer J, Coughlin MJ, Stevens F (2014). "Prospective study of hammertoe correction with an intramedullary implant". Foot Ankle Int. 35 (4): 319–25. doi:10.1177/1071100713519780. PMID 24443491.
↑ Obrador C, Losa-Iglesias M, Becerro-de-Bengoa-Vallejo R, Kabbash CA (2018). "Comparative Study of Intramedullary Hammertoe Fixation". Foot Ankle Int. 39 (4): 415–425. doi:10.1177/1071100717745854. PMID 29337598.
↑ Kramer WC, Parman M, Marks RM (2015). "Hammertoe correction with k-wire fixation". Foot Ankle Int. 36 (5): 494–502. doi:10.1177/1071100714568013. PMID 25677363.

Template:Diseases of the musculoskeletal system and connective tissue

de:Hammerzehe

Template:WikiDoc Sources

[pmid30309185-1] Ridley LJ, Han J, Ridley WE, Xiang H (2018). "Claw toe". J Med Imaging Radiat Oncol. 62 Suppl 1: 126. doi:10.1111/1754-9485.07_12786. PMID 30309185.

[pmid30553747-2] Ceccarini P, Rinonapoli G, Sebastiani E, Bisaccia M, Ceccarini A, Caraffa A (2019). "Clinical Comparison Between Shortening Osteotomy of the Proximal Phalanx Neck and Arthrodesis in Hammer Toe Surgery at Mid-TermFollow-Up". J Foot Ankle Surg. 58 (2): 221–225. doi:10.1053/j.jfas.2018.08.002. PMID 30553747.

[pmid29362037-3] Doty JF, Fogleman JA (2018). "Treatment of Rigid Hammer-Toe Deformity: Permanent Versus Removable Implant Selection". Foot Ankle Clin. 23 (1): 91–101. doi:10.1016/j.fcl.2017.09.007. PMID 29362037.

[pmid29444584-4] Mueller CM, Boden SA, Boden AL, Maidman SD, Cutler A, Mignemi D; et al. (2018). "Complication Rates and Short-Term Outcomes After Operative Hammertoe Correction in Older Patients". Foot Ankle Int. 39 (6): 681–688. doi:10.1177/1071100718755472. PMID 29444584.

[pmid25746765-5] Ceccarini P, Ceccarini A, Rinonapoli G, Caraffa A (2015). "Correction of Hammer Toe Deformity of Lateral Toes With Subtraction Osteotomy of the Proximal Phalanx Neck". J Foot Ankle Surg. 54 (4): 601–6. doi:10.1053/j.jfas.2014.11.013. PMID 25746765.

[pmid26028601-6] Basile A, Albo F, Via AG (2015). "Intramedullary Fixation System for the Treatment of Hammertoe Deformity". J Foot Ankle Surg. 54 (5): 910–6. doi:10.1053/j.jfas.2015.04.004. PMID 26028601.

[pmid24443491-7] Catena F, Doty JF, Jastifer J, Coughlin MJ, Stevens F (2014). "Prospective study of hammertoe correction with an intramedullary implant". Foot Ankle Int. 35 (4): 319–25. doi:10.1177/1071100713519780. PMID 24443491.

[pmid29337598-8] Obrador C, Losa-Iglesias M, Becerro-de-Bengoa-Vallejo R, Kabbash CA (2018). "Comparative Study of Intramedullary Hammertoe Fixation". Foot Ankle Int. 39 (4): 415–425. doi:10.1177/1071100717745854. PMID 29337598.

[pmid25677363-9] Kramer WC, Parman M, Marks RM (2015). "Hammertoe correction with k-wire fixation". Foot Ankle Int. 36 (5): 494–502. doi:10.1177/1071100714568013. PMID 25677363.

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@@ Line 13: / Line 13: @@
 }}
 {{SI}}
-{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}}
+{{CMG}}; '''Associate Editor-In-Chief:'''{{S.M.}}, {{CZ}}
 {{SK}} Claw toe; hammertoe syndrome; mallet toe
 ==Overview==
-A '''hammer toe''' is a [[deformity]] of the second, third, or fourth [[toe]] causing it to be permanently bent at the [[proximal interphalangeal joint]], resembling a hammer. '''Mallet toe''' is another name for this condition when affecting the [[distal interphalangeal joint]].
+A '''hammer [[toe]]''' is a [[deformity]] of the [[second]], third, or fourth [[toe]] [[Causes|causing]] it to be permanently [[Bent bond|bent]] at the [[proximal interphalangeal joint]], resembling a hammer. '''Mallet [[toe]]''' is another name for this [[condition]] when [[Affect|affecting]] the [[distal interphalangeal joint]].
+==Pathophysiology==
+*Hammer [[toe]] occurs due to [[abnormal]] (permanent) [[Bends|bend]] at the [[proximal interphalangeal joint]] of a [[toe]] due to [[imbalance]] in the [[muscles]], [[ligaments]], or [[tendons]] which normally [[Holdfast|hold]] the [[toe]] in a [[Straight, Incorporated|straight]] [[Position effect|position]]
+==Risk factors==
+Common [[risk factors]] include:
+*Advancing [[age]]
+*[[Female]] [[Sex (activity)|sex]]
+*[[Length]] of the [[second]] [[toe]] greater than the [[big toe]]
+*[[Osteoarthritis]]
+*[[Rheumatoid arthritis]]
+*[[Diabetes]]
+==Complications==
+[[Fewmets|Few]] [[complications]] of hammer [[toe]] include:
+*Permanent [[Bent bond|bent]] of the [[toe]] if not [[Treatments|treated]] initially when [[toe]] is [[Flexibility (anatomy)|flexible]]
+*[[Painful]] [[Corns & calluses (patient information)|corns or calluses]] due to rubbing of [[toes]] against the inside of [[foot]]
 ==Causes==
-Hammer toe most often results from wearing poorly-fit shoes that can force the toe against their tip, such as excessively high heels or shoes that are too short or narrow for the foot. This can lead to [[subluxation]] of the metatarsal phalangeal joints and formation of a hammer toe, often found in conjunction with [[bunion]]s or other foot problems. It can also be caused by muscle, nerve, or joint damage resulting from conditions such as [[osteoarthritis]], [[rheumatoid arthritis]], [[stroke]], [[Charcot-Marie-Tooth disease]] or [[diabetes]].<ref name="pmid30309185">{{cite journal| author=Ridley LJ, Han J, Ridley WE, Xiang H| title=Claw toe. | journal=J Med Imaging Radiat Oncol | year= 2018 | volume= 62 Suppl 1 | issue=  | pages= 126 | pmid=30309185 | doi=10.1111/1754-9485.07_12786 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30309185  }} </ref><ref name="pmid30553747">{{cite journal| author=Ceccarini P, Rinonapoli G, Sebastiani E, Bisaccia M, Ceccarini A, Caraffa A| title=Clinical Comparison Between Shortening Osteotomy of the Proximal Phalanx Neck and Arthrodesis in Hammer Toe Surgery at Mid-TermFollow-Up. | journal=J Foot Ankle Surg | year= 2019 | volume= 58 | issue= 2 | pages= 221-225 | pmid=30553747 | doi=10.1053/j.jfas.2018.08.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30553747  }} </ref>
+Common [[causes]] of [[muscle]], [[nerve]], or [[Joint (anatomy)|joint]] damage [[Result|resulting]] in a hammer [[toe]] include:<ref name="pmid30309185">{{cite journal| author=Ridley LJ, Han J, Ridley WE, Xiang H| title=Claw toe. | journal=J Med Imaging Radiat Oncol | year= 2018 | volume= 62 Suppl 1 | issue=  | pages= 126 | pmid=30309185 | doi=10.1111/1754-9485.07_12786 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30309185  }} </ref><ref name="pmid30553747">{{cite journal| author=Ceccarini P, Rinonapoli G, Sebastiani E, Bisaccia M, Ceccarini A, Caraffa A| title=Clinical Comparison Between Shortening Osteotomy of the Proximal Phalanx Neck and Arthrodesis in Hammer Toe Surgery at Mid-TermFollow-Up. | journal=J Foot Ankle Surg | year= 2019 | volume= 58 | issue= 2 | pages= 221-225 | pmid=30553747 | doi=10.1053/j.jfas.2018.08.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30553747  }} </ref>
+*[[Wear red day|Wearing]] poorly-fit [[Shoe insert|shoes]] that can [[force]] the [[toe]] against their [[Tippy toes|tip]], such as:
+**Excessively high [[Heel|heels]]
+**[[Shoe insert|Shoes]] that are too short or narrow for the [[foot]]
+**[[Osteoarthritis]]
+**[[Rheumatoid arthritis]]
+**[[Stroke]]
+**[[Charcot-Marie-Tooth disease]]
+**[[Diabetes]]
+==History and symptoms==
+*Hammer [[toe]] usually involves the [[second]], third, or fourth [[toe]]
+*Common [[symptoms]] include:
+**[[Abnormal]] [[Bends|bend]] in the [[Joint (anatomy)|joint]] of one or more [[toes]] resembling a hammer
+**[[Painful]] or difficult [[Movement disorder|movement]] of the [[Affect|affected]] [[toe]]
+**[[Painful]] [[Callus (cell biology)|calluses]] & [[corns]] may form (due to rubbing of hammer [[toes]] against the inside of the [[Shoe insert|shoes]])
 ==Treatment==
-In many cases, conservative treatment consisting of [[physical therapy]] and new shoes with soft, spacious toe boxes is enough to resolve the condition, while in more severe or longstanding cases [[orthopedic surgery]] may be necessary to correct the deformity.<ref name="pmid29362037">{{cite journal| author=Doty JF, Fogleman JA| title=Treatment of Rigid Hammer-Toe Deformity: Permanent Versus Removable Implant Selection. | journal=Foot Ankle Clin | year= 2018 | volume= 23 | issue= 1 | pages= 91-101 | pmid=29362037 | doi=10.1016/j.fcl.2017.09.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29362037  }} </ref><ref name="pmid29444584">{{cite journal| author=Mueller CM, Boden SA, Boden AL, Maidman SD, Cutler A, Mignemi D et al.| title=Complication Rates and Short-Term Outcomes After Operative Hammertoe Correction in Older Patients. | journal=Foot Ankle Int | year= 2018 | volume= 39 | issue= 6 | pages= 681-688 | pmid=29444584 | doi=10.1177/1071100718755472 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29444584  }} </ref>
+===Conservative treatment===
+*In many [[Case-based reasoning|cases]], conservative [[Treatments|treatment]] is enough to resolve the [[condition]] such as:
+**[[Physical therapy]]
+**[[New]] [[Shoe insert|shoes]] with soft, spacious [[toe]] [[Box|boxes]]
+===Surgery===
+*In more severe or longstanding [[Case-based reasoning|cases]], [[orthopedic surgery]] may be [[Necessary and sufficient|necessary]] to [[Corrective|correct]] the [[deformity]]<ref name="pmid29362037">{{cite journal| author=Doty JF, Fogleman JA| title=Treatment of Rigid Hammer-Toe Deformity: Permanent Versus Removable Implant Selection. | journal=Foot Ankle Clin | year= 2018 | volume= 23 | issue= 1 | pages= 91-101 | pmid=29362037 | doi=10.1016/j.fcl.2017.09.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29362037  }} </ref><ref name="pmid29444584">{{cite journal| author=Mueller CM, Boden SA, Boden AL, Maidman SD, Cutler A, Mignemi D et al.| title=Complication Rates and Short-Term Outcomes After Operative Hammertoe Correction in Older Patients. | journal=Foot Ankle Int | year= 2018 | volume= 39 | issue= 6 | pages= 681-688 | pmid=29444584 | doi=10.1177/1071100718755472 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29444584  }} </ref><ref name="pmid25746765">{{cite journal| author=Ceccarini P, Ceccarini A, Rinonapoli G, Caraffa A| title=Correction of Hammer Toe Deformity of Lateral Toes With Subtraction Osteotomy of the Proximal Phalanx Neck. | journal=J Foot Ankle Surg | year= 2015 | volume= 54 | issue= 4 | pages= 601-6 | pmid=25746765 | doi=10.1053/j.jfas.2014.11.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25746765  }} </ref><ref name="pmid26028601">{{cite journal| author=Basile A, Albo F, Via AG| title=Intramedullary Fixation System for the Treatment of Hammertoe Deformity. | journal=J Foot Ankle Surg | year= 2015 | volume= 54 | issue= 5 | pages= 910-6 | pmid=26028601 | doi=10.1053/j.jfas.2015.04.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26028601  }} </ref><ref name="pmid24443491">{{cite journal| author=Catena F, Doty JF, Jastifer J, Coughlin MJ, Stevens F| title=Prospective study of hammertoe correction with an intramedullary implant. | journal=Foot Ankle Int | year= 2014 | volume= 35 | issue= 4 | pages= 319-25 | pmid=24443491 | doi=10.1177/1071100713519780 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24443491  }} </ref><ref name="pmid29337598">{{cite journal| author=Obrador C, Losa-Iglesias M, Becerro-de-Bengoa-Vallejo R, Kabbash CA| title=Comparative Study of Intramedullary Hammertoe Fixation. | journal=Foot Ankle Int | year= 2018 | volume= 39 | issue= 4 | pages= 415-425 | pmid=29337598 | doi=10.1177/1071100717745854 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29337598  }} </ref><ref name="pmid25677363">{{cite journal| author=Kramer WC, Parman M, Marks RM| title=Hammertoe correction with k-wire fixation. | journal=Foot Ankle Int | year= 2015 | volume= 36 | issue= 5 | pages= 494-502 | pmid=25677363 | doi=10.1177/1071100714568013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25677363  }} </ref>
+==Prevention==
+[[Primary prevention|Primary preventive]] [[Measure (mathematics)|measures]] for hammer [[toe]] include:
+*Buying the [[Shoe insert|shoes]] with following [[Characteristic impedance|characteristics]]:
+**Proper fitting
+**Low [[Heel|heels]]
+**Adequate [[toe]] room ([[Avoidance response|avoiding]] [[Shoe insert|shoes]] with [[Point (geometry)|pointed]] [[toes]])
+**More roomier and adjustable (laced or strapped [[Shoe insert|shoes]])
 ==References==


Hammer toe
A Mallet Toe is evident on the 3rd digit
ICD-10	M20.4, Q66.8
ICD-9	735.4, 755.66
MeSH	D037801