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==Overview== | ==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]] 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== | |||
*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== | |||
*Advancing age | |||
*Female sex | |||
*Length of second toe greater than big toe | |||
*Osteoarthritis | |||
*Rheumatoid arthritis | |||
*Diabetes | |||
==Complications== | |||
*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== | ==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> | 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> | ||
==History and symptoms== | |||
*Usually affects second, third, or fourth toe | |||
*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== | ==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><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> | 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><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 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== | ==References== | ||
Revision as of 15:34, 26 June 2019
| Hammer toe | |
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|---|---|
| A Mallet Toe is evident on the 3rd digit | |
| ICD-10 | M20.4, Q66.8 |
| ICD-9 | 735.4, 755.66 |
| MeSH | D037801 |
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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
- 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
- Advancing age
- Female sex
- Length of second toe greater than big toe
- Osteoarthritis
- Rheumatoid arthritis
- Diabetes
Complications
- 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
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 bunions 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.[1][2]
History and symptoms
- Usually affects second, third, or fourth toe
- 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
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.[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.
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