Deformities of the toes are defined by the specific joint where the toe is contracted. For example, a “mallet toe” is a contraction of the distal interphalangeal joint, or the end of the toe. A “claw toe” is contraction at both the two joints of the toe. And finally, a “hammer toe” is contraction at one joint and extension of the other. Any of these deformities can lead to pain from rubbing in shoes, causing sensitive corns and calluses. In diabetic or neuropathic patients it is particularly important to monitor these deformities to prevent sores at the contracted portions of the toes.
Hammertoes are caused as a result of overworking of different muscle groups. Most often this occurs in people with decreased arch, or overpronation, and the tendons that flex the toes work harder to provide power with walking, leading to hammertoes. Another reason can be from the tendons on the top of the foot which overwork due to a high arch foot, or pes cavus. The last mechanism is due to a weak muscle in the back of the leg (triceps surae) which causes the deep muscles of the lower leg to overwork.
Regardless of the cause of the problem, hammertoes can cause pain and further deformity in the foot. The surgical options for hammertoes are many, and each year more products become available. The tradition method for stabilizing a contracted digit surgically has been the use of pins, known as K-wires. These wires are introduced through the end of the toe to maintain the position of the bones until the fusion site is healed. Now, many other implants are available and are still undergoing research to determine if they provide better results.
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