Hammer toe
Encyclopedia
A hammer toe or contracted toe is a deformity
of the proximal interphalangeal joint
of the second, third, or fourth toe
causing it to be permanently bent, resembling a hammer
. Mallet toe is a similar condition affecting the distal interphalangeal joint.
Claw toe is another similar condition, with dorsiflexion
of the proximal phalanx on the lesser metatarsophalangeal joint
, combined with flexion
of both the proximal and distal interphalangeal joints. Claw toe can affect the second, third, fourth, or fifth toes.
s that can force the toe into a bent position, such as excessively high heels or shoes that are too short or narrow for the foot. Having the toes bent for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity. This is 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. Hammer toe can also be found in Friedrich's ataxia (GAA trinucleotide repeat).
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.
The patient's doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor. While watching television or reading, one can put a towel flat under the feet and use the toes to crumple it. The doctor can also prescribe a brace that pushes down on the toes to force them to stretch out their muscles.
Deformity
A deformity, dysmorphism, or dysmorphic feature is a major difference in the shape of body part or organ compared to the average shape of that part.Deformity may arise from numerous causes:*A Genetic mutation*Damage to the fetus or uterus...
of the proximal interphalangeal joint
Interphalangeal articulations of foot
The interphalangeal articulations of the foot are the joints between the phalanges of the toes. They are ginglymoid joints, and each has a plantar and two collateral ligaments...
of the second, third, or fourth toe
Toe
Toes are the digits of the foot of a tetrapod. Animal species such as cats that walk on their toes are described as being digitigrade. Humans, and other animals that walk on the soles of their feet, are described as being plantigrade; unguligrade animals are those that walk on hooves at the tips of...
causing it to be permanently bent, resembling a hammer
Hammer
A hammer is a tool meant to deliver an impact to an object. The most common uses are for driving nails, fitting parts, forging metal and breaking up objects. Hammers are often designed for a specific purpose, and vary widely in their shape and structure. The usual features are a handle and a head,...
. Mallet toe is a similar condition affecting the distal interphalangeal joint.
Claw toe is another similar condition, with dorsiflexion
Dorsiflexion
Dorsiflexion is the movement which decreases the angle between the dorsum of the foot and the leg, so that the toes are brought closer to the shin. The movement moving in opposite directions is called plantarflexion...
of the proximal phalanx on the lesser metatarsophalangeal joint
Metatarsophalangeal articulations
The metatarsophalangeal articulations are the joints between the metatarsal bones of the foot and the proximal bones of the toes...
, combined with flexion
Flexion
In anatomy, flexion is a position that is made possible by the joint angle decreasing. The skeletal and muscular systems work together to move the joint into a "flexed" position. For example the elbow is flexed when the hand is brought closer to the shoulder...
of both the proximal and distal interphalangeal joints. Claw toe can affect the second, third, fourth, or fifth toes.
Causes
Hammer toe most frequently results from wearing poorly fitting shoeShoe
A shoe is an item of footwear intended to protect and comfort the human foot while doing various activities. Shoes are also used as an item of decoration. The design of shoes has varied enormously through time and from culture to culture, with appearance originally being tied to function...
s that can force the toe into a bent position, such as excessively high heels or shoes that are too short or narrow for the foot. Having the toes bent for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity. This is often found in conjunction with bunion
Bunion
A bunion is a deformity characterized by lateral deviation of the great toe, often erroneously described as an enlargement of bone or tissue around the joint at the head of the big toe...
s or other foot problems. It can also be caused by muscle, nerve, or joint damage resulting from conditions such as osteoarthritis
Osteoarthritis
Osteoarthritis also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion...
, rheumatoid arthritis
Rheumatoid arthritis
Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium secondary to hyperplasia of synovial cells, excess synovial fluid, and the development...
, stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
, Charcot-Marie-Tooth disease
Charcot-Marie-Tooth disease
Charcot–Marie–Tooth disease- , known also as Morbus Charcot-Marie-Tooth, Charcot-Marie-Tooth neuropathy, hereditary motor and sensory neuropathy , hereditary sensorimotor neuropathy , or peroneal muscular atrophy, is an inherited disorder of nerves that takes different forms...
or diabetes. Hammer toe can also be found in Friedrich's ataxia (GAA trinucleotide repeat).
Treatment
In many cases, conservative treatment consisting of physical therapyPhysical therapy
Physical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...
and new shoes with soft, spacious toe boxes is enough to resolve the condition, while in more severe or longstanding cases orthopedic surgery
Orthopedic surgery
Orthopedic surgery or orthopedics is the branch of surgery concerned with conditions involving the musculoskeletal system...
may be necessary to correct the deformity.
The patient's doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor. While watching television or reading, one can put a towel flat under the feet and use the toes to crumple it. The doctor can also prescribe a brace that pushes down on the toes to force them to stretch out their muscles.