A person of any age can have toe problems, from an infant born with deformities to older adults with acquired deformities. The major culprit of adult toe deformities is tendon imbalance. The tendons may tighten or stretch in order to compensate for an imbalance of the foot which leads to a deformity of the toes. Thus, people who have abnormally long toes, high arches, or flat feet have a greater tendency to develop deformities in their toes. Over time, a person's toes may become permanently deformed and arthritic changes can develop. The most common deformities of the toes are claw toes, hammertoes, bone spurs, mallet toes, under-lapping and overlapping toes, and curled toes. These deformities can lead to calluses or corns and inflammation of the small protective pouches over the deformed joints which will lead to swelling and pain. Pain may or may not be present.
Hammertoe is a condition in which a person's toe is bent into a claw-like position. This condition can be present in more than one toe, but most commonly it is in the second toe. Hammertoe is described as a deformity in which the toes bend downward with the toe join typically enlarged. Over time, the person's joint will enlarge and stiffen as it rubs against their shoes. Other foot structures that can be involved include the overlying skin and blood vessels and the nerves that are connected to the involved toes.
The shortening of one's tendons is responsible for the movement and control of the affected toes or toe which will cause hammertoe. Top portions of a person's toes will become callused from the friction that is produced from rubbing against the inside of the shoes. This foot problem will often be a result of improper footwear. This will especially be the case with high-heeled shoes placing pressure on the front part of one's foot that compresses the smaller toes tightly together. The condition will frequently stem from muscle imbalance, and will typically leave the affected individual with impaired balance. A thorough medical history and a physical exam by a physician will always be necessary for a proper diagnosis of hammertoe along with various other foot conditions. Because the condition involves a deformity of one's bones, an x ray can help to confirm the diagnosis.
By wearing properly fitting stockings and footwear with plenty of room in the toe region treatment can be provided for hammertoe. Stretching exercises may also be helpful in lengthening the excessively tight tendons. In advanced situations, where conservative treatment is not successful, surgery may be recommended. The tendons that are attached to the involved toes will be located and an incision will be made to free the connective tissue to the foot bones. Additional incisions may be made so that the toes no longer bend in a downward fashion. The middle joints of the affected toes are connected together permanently with surgical hardware such as wire sutures and pins. The incision will then be closed with fine sutures. These sutures will be removed roughly seven to ten days after the procedure.
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