Hammertoe and mallet toe
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Hammertoe and mallet toe are foot conditions characterized by a bending of one or more toes. Ill-fitting shoes, foot injuries, and certain medical conditions like diabetes are common causes, although sometimes the exact cause is unknown.
Mallet toe involves two specific areas of the body: the distal interphalangeal joint (DIPJ) and the flexor digitorum longus (FDL). The DIPJ is the joint closest to the toenail, while the FDL is a muscle that runs from the shin to the smaller toes, aiding in toe curling. When the FDL becomes too tight, it can lead to an upward bend in the toe joint. Conversely, hammertoe presents an unusual bend in the middle joint of a toe. Typically, these conditions affect the second, third, and fourth toes.
Treatment options include changing footwear, using shoe inserts, and employing other supportive devices to alleviate pain and pressure. In cases where conservative measures fail, surgery may be recommended to correct the condition and relieve discomfort.
Symptoms
Hammertoe and mallet toe are characterized by an abnormal bending in the joints of one or more toes. Additional symptoms may include:
- Stiffness in the toe.
- Inflammation and redness.
- Challenges in moving the impacted toe.
- Formation of corns and calluses due to friction with shoes or the ground.
- Sores or ulcers on the toes, particularly in individuals with diabetes.
- Discomfort caused by shoe wear.
Consult a doctor if persistent foot pain hinders your ability to walk.
Causes
Hammertoe and mallet toe are associated with:
- Specific types of footwear. High-heeled shoes or shoes with a tight toe box can compress toes, preventing them from lying flat. Over time, this pressure may cause the toe to stay curled even when not wearing shoes.
- Trauma. Toes that have been stubbed, jammed, or broken are at an increased risk of developing hammertoe or mallet toe.
- Muscle imbalance in the toes. When the muscles are not evenly balanced, they can exert pressure on the tendons and joints, eventually leading to the development of hammertoe and mallet toe.
- Arthritis
Risk factors
Factors contributing to a higher risk of hammertoe and mallet toe include:
- Gender. Women are more prone to developing hammertoe or mallet toe compared to men.
- Specific health conditions. Conditions like arthritis and diabetes elevate the likelihood of experiencing foot issues. Genetic factors may also contribute to the risk.
Diagnosis
Diagnosis of hammertoe or mallet toe typically requires evaluation by a healthcare professional, such as your primary care physician (PCP) or a podiatrist specializing in foot and ankle issues. The process usually involves:
- Examination of your footwear.
- Assessment of the affected toe’s flexibility.
- Possibly conducting a gait analysis to observe your walking pattern.
- Performing a thorough foot and ankle examination.
- Debriding (removing) any painful skin or nail.
- X-ray imaging of the foot to identify any fractures or abnormalities.
Through these steps, your healthcare provider can determine if there’s additional pressure or stress on the affected toe and decide if further imaging tests are necessary to confirm the diagnosis or rule out fractures.
Treatment
Most cases of mallet toe find relief through non-surgical treatments. If the condition is still flexible, your healthcare provider might suggest:
- Gentle exfoliation: Smoothing calluses to alleviate discomfort.
- Toe pads: Placing pads on corns or calluses to reduce pressure.
- Steroid injections: Decreasing inflammation with medical injections.
- Toe stretching: Regularly stretching the toes to maintain flexibility.
- Orthotics: Utilizing specialized shoe inserts to relieve toe pressure.
- Roomy shoes: Opting for footwear with extra toe space.
Foot care for dabetes patients: For individuals with diabetes, proper foot care is crucial. Here are some essential tips:
- Daily foot checks: Inspect feet for any signs of sores or injuries.
- Hygiene maintenance: Keep feet clean and dry to prevent infections.
- Regular nail trimming: Trim toenails regularly to avoid complications.
- Professional assessment: Refrain from self-treating corns or calluses, always seek medical advice.
Possibility of surgery: In cases of severe or rigid mallet toes, conservative treatments may not suffice. Surgical intervention might be necessary to restore joint alignment. Surgical options include:
- Arthroplasty: Removing a portion of the bent toe bone and realigning it.
- Tendon release: Cutting tight toe tendons to facilitate a flat toe position.
- Tendon transfer: Transferring the mallet toe tendon to another foot area to promote straightening.
Remember to consult with a healthcare provider for personalized treatment recommendations.
