Materiały źródłowe

• #1 Hammertoe – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559268/

  Hammertoes are among the most common deformities of the forefoot. […] Hammertoe is a deformity that involves flexion at the interphalangeal joints (IPJ) and can be distinguished into categories including the classic hammertoe, mallet toe or claw toe. […] It results from an imbalance between the weak intrinsic muscles and the stronger extrinsic muscles surrounding the metatarsophalangeal joints (MTPJ) of the lesser digits. […] The causes of hammertoe deformity are many and multifactorial, including congenital and acquired, with the most accepted factor and component being a biomechanical dysfunction. […] The etiology of deformities of the lesser digits includes: Neuromuscular conditions, Diabetes, Inflammatory arthropathies, Ill-fitting shoes and high heels, Intrinsic muscle imbalance, Hallux valgus, Long metatarsals, Pes planus.

• #1 The pathology and management of lesser toe deformities

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5367573/

  Deformities of the lesser toes often occur gradually, though they can be brought on by trauma. Ill-fitting or high-heeled footwear is often implicated in the causation of deformity. Hallux valgus can contribute to the formation and propagation of lesser toe deformities as effective shortening of the first ray may slacken the plantar fascia and weaken the windlass effect on the first toe. This in turn leads to greater strain on the lesser toes, which makes their supporting structures more likely to fail. Pathology can also be linked to inflammatory arthritis, synovitis, diabetes mellitus and neuromuscular disorders. […] The main adult sagittal plane deformities consist of claw toes, hammer toes and mallet toes. Axial plane deformities include crossover toes. These deformities have been variously defined in the literature, perhaps in part because the treatment for claw and hammer toes is not very different. However, in this review we use the same definitions as Coughlin and Stainsby. They defined a mallet toe as an isolated flexion deformity of the DIPJ and described a hammer toe as a primary flexion deformity of the PIPJ, with or without hyperextension at the MTPJ, but with a neutral or hyperextended DIPJ. Most authors define a claw toe as a primary hyperextension deformity of the MTPJ with flexion at the PIPJ and DIPJ, and a crossover toe as a deviation of the toe in the axial plane associated with hyperextension at the MTPJ.

• #1 The pathology and management of lesser toe deformities

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5367573/

  These deformities may occur as a result of an imbalance between the forces of extension and flexion about the relevant joints. […] The DIPJ deformity in the mallet toes is often attributed to tightness in shoes. Initially the DIPJ flexes due to direct pressure from the shoe but eventually the FDL tightens, causing a persistent deformity. This may be associated with callosities on the tip of the toe and pressure on the nail. The mallet deformity is flexible in the early stages, but as the collaterals and capsule tighten the deformity becomes fixed. […] In a hammer toe, the first deformity is at the PIPJ. This occurs in a similar manner to the mallet toe. It is often seen in the fifth and sixth decades of life and is associated with hallux valgus and inflammatory arthritis. Although footwear plays a significant role in its development, trauma can result in an acute rupture of the central slip of the extensor tendon which may cause the deformity.

• #1 Hammertoe Deformity: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1236338-overview

  Hammertoe deformity is the most common deformity of the lesser toes. The fundamental problem is a chronic, sustained imbalance between flexion and extension forces applied to the lesser toes. These imbalanced forces involve intrinsic and extrinsic tendons of the foot. […] The fundamental problem is a chronic, sustained imbalance between flexion and extension force of the lesser toes from intrinsic forces, extrinsic forces, or both. Hammertoe deformity primarily involves flexion deformity of the PIP joint of the toe, with hyperextension of the MTP and DIP joints. […] When the second ray of the foot is longer than the first and shoewear is improperly fitted, flexion of the PIP joint occurs to accommodate the shoe. This length difference also causes MTP synovitis to develop from overuse of the second MTP joint. Attenuation of the collateral ligaments and plantar plate results, and the MTP joint hyperextends and may even progress to dorsal subluxation or dislocation.

• #1 Hammertoe – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559268/

  There are different types of characteristics of the digital deformities; they may be static or dynamic, flexible or rigid and may occur in conjunction with other pathologies such as Charcot-Marie-Tooth disease, cavus deformity and rheumatoid arthritis (RA). […] There are three major categories explaining the cause of the deformity and the loss of intrinsic and extrinsic muscle balance at the MTPJ; flexor stabilization, extensor substitution, and flexor substitution. […] Flexor Stabilization – the most common cause of digital deformities and occurs with excessive pronation. […] Flexor substitution – occurs when there is a weak triceps surae muscle, and the deep and lateral leg muscles try to compensate for inadequate plantarflexion. […] Extensor substitution – clinically recognizable by bowstringing of the extensor tendons. […] Whether due to neuromuscular, anatomic abnormalities such as the second ray being longer than the first or improperly fitted shoes, there is an imbalance in the extrinsic or intrinsic forces that are exerted on the digit causing a deformity.

• #1 Hammertoe Deformity: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1236338-overview

  With all three of these etiologies, the EDL tendon gradually loses mechanical advantage at the PIP joint, as does the FDL tendon at the MTP joint. The intrinsic muscles subluxate dorsally as the MTP hyperextends. They now extend the MTP joint and flex the PIP joint, as opposed to their usual functions of flexing the MTP joint and extending the PIP joint.

• #1 The pathology and management of lesser toe deformities

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5367573/

  In a claw toe – commonly seen in neuromuscular disorders – the first causative deformity is thought to be hyperextension at the MTPJ, but the exact mechanism is unclear. When the MTPJ becomes chronically hyperextended, the intrinsics shorten and the axis of pull shifts dorsal to the centre of rotation of the MTPJ. The intrinsics can therefore no longer produce a flexion moment at the MTPJ and the extensors act unopposed. The flexors are pulled taut and flex the IPJs. […] Initially this clawing may be dynamic and only noticeable on walking. Over time the plantar plate tears, subluxation occurs at the MTPJ, and the deformity becomes permanent. In both claw and hammer toes the reverse windlass mechanism eventually fails and the toes cannot be brought into contact with the ground during gait. More force is then taken over the MT heads which results in metatarsalgia.

• #1 Facts About Hammertoe and Mallet Toe Deformities | Shenandoah Podiatry

  https://www.shenandoahpodiatry.com/library/facts-about-hammertoe-and-mallet-toe-deformities.cfm

  Conditions like hammertoe and mallet toe deformities can cause a great deal of foot and heel pain if left untreated. […] The root cause of hammertoe and mallet toe relates to the imbalance between the muscles and connective tissues in the toe and foot. If the toe is bent in a position for a prolonged period of time, the muscles and joints may tighten. As a result, they become unable to stretch out from that position. […] Causes relating to toe deformities include: […] Muscle balance. If the toe muscles are imbalanced or weak, this can lead to an instability in how you walk. This can then force your toe or toes to contract. […] Bone imbalance. Foot bones that are too short or otherwise imbalanced can also lead to hammertoe and mallet toe.

• #1 Hammer Toes : Wheeless’ Textbook of Orthopaedics

  https://www.wheelessonline.com/muscles-tendons/hammer-toes/

  – pathogenesis: – may involve contracture of FDL tendon; – when this is the case look for a dynamic deformity, ie., the hammer toe is worse when the patient stands or walks; – long second metatarsal may be a predisposing factor; – high heels and crowded shoe wear are also common causes; – less common causes are RA, cross over deformity, diabetes; – in rare cases hammer toe deformity may be due to plantar fascia release; – w/ MP joint contracture, contracture of EDL may prevent the MP joint from obtaining a neutral position; – main action of the EDL is to dorsiflex the phalanx, but can only do so when the phalanx is in a neutral or flexed position; […] – if long metatarsal is a strong risk factor, and the EHL/EDL is the most important dynamic deforming force; – it usually subsides after 3 to 6 months, but may go on to frank dorsal subluxation; – w/ dorsal dislocation, there will usually be attenuation of the volar plate; – after it has subsided patient may be left with subluxated MTP joint fixed hammer toes deformity;

• #1 What causes hammertoe and mallet toe? – Beaver Valley Foot Clinic

  https://bvfootclinic.com/what-causes-hammertoe-and-mallet-toe/

  Genetics: There is evidence to suggest that genetics can predispose individuals to certain foot deformities, including hammer toe and mallet toe. If a persons parents or other close relatives have had these conditions, they may be more likely to develop them as well. […] Foot Mechanics: Certain foot structures or biomechanical abnormalities, which can be inherited, may increase the risk of developing hammer toe and mallet toe. For example, having a high arch or flat foot can alter the distribution of weight on the foot and contribute to toe deformities. […] Yes, hammer toe and mallet toe can lead to other foot problems if left untreated. Some potential complications and related foot problems associated with hammer toe and mallet toe include: […] Corns and Calluses: The abnormal toe positions in hammer toe and mallet toe can cause friction and pressure against the inside of shoes, leading to the formation of corns and calluses. These can be painful and may require treatment to alleviate discomfort. […] Bursitis: Inflammation of the bursa, a fluid-filled sac that cushions and lubricates joints, can occur in the affected toes due to constant rubbing against shoes. This can cause pain, swelling, and redness in the affected area.

• #1 Mallet Toes: Symptoms, Causes and Treatment | Foot Solutions

  https://footsolutions.com/foot-problems-we-help/mallet-toes/

  If your toes appear crooked or bent downward you may be suffering from hammer toes, mallet toes or claw toes. […] These three very similar toe deformities result in shortening of the toe tendons thereby limiting toe motion, and causing claw-shaped toes and painful rubbing inside shoes. […] Poor foot function such as over pronation (excessive inward rolling of the foot) or oversupination (excessive outward rolling of the foot) are common causes of hammer, mallet and claw toes. […] Poor fitting shoes are also a common cause. […] Various forms of arthritis can also lead to many different forefoot deformities, including hammer, mallet and claw toes. […] Changing the type of footwear worn is a very important step in addressing Mallet Toes. […] If over pronation or over supination exist, arch supports can improve or restore proper foot function and reduce further development of the deformity. […] If the deformity is flexible, the use of arch supports, hammer toe splints, and custom toe splints can improve and, in some cases, restore proper toe position and function.

• #1 Hammer Toe: Comprehensive Guide – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/hammer-toe/

  A hammer toe is a deformity of the second, third, or fourth toes. In this condition, the toe is bent at the middle joint, so that it resembles a hammer. […] Hammer toe is the result of a muscle imbalance that puts pressure on the toe tendons and joints. Muscles work in pairs to straighten and bend the toes. If the toe is bent in one position long enough, the muscles and joints tighten and cannot stretch out. […] Wearing shoes that do not fit properly is a common cause of this imbalance. Shoes that narrow toward the toe push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of corns and calluses, which further aggravate the condition. Shoes with a higher heel force the foot down and push the toes against the shoe, increasing the pressure and the bend in the toe. Other times, some of the small muscles in the foot can weaken over time and cause an imbalance. Eventually, the toe muscles can no longer straighten the toe.

• #1 What causes hammertoe and mallet toe? – Beaver Valley Foot Clinic

  https://bvfootclinic.com/what-causes-hammertoe-and-mallet-toe/

  Hammertoe symptoms PittsburghThese hammertoe deformities have several well-established causes which include: […] Poorly fitting footwear: any shoes or boots which dont allow the toes to lie flat have the potential to cause either deformity. Overly tight toe boxes are also major contributors. Note that high-heeled shoes are notorious for causing these conditions and several others. […] Injury: trauma such as a severely stubbed toe can set a patient up for hammer or mallet toe. Poorly set fractures can also play a role. […] Abnormal toe musculature: this can cause poor biomechanics which can lead to a host of foot conditions. This includes the deformities mentioned above. […] Age and genetics can both play significant roles in the development of hammer toe and mallet toe: […] Age: As people age, the ligaments and tendons in their feet may weaken or become less flexible, leading to changes in foot structure and function. Additionally, the natural aging process can result in a loss of fat pads in the ball of the foot, which can contribute to the development of hammer toe and mallet toe.

• #1 Hammertoe Repair – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/600_699/0636.html

  Deformities of the lesser (two through five) toes are generally known as hammer toe, claw toe and mallet toe. […] Hammer toes are classified as either flexible (passively correctable) or rigid (not passively correctable to the neutral position). […] More commonly, the deformity occurs slowly or chronically. Neuromuscular diseases such as cerebral palsy, polio, Charcot Marie Tooth disease, stroke, closed-head injury; or nerve injury or other rare, neuromuscular problems can cause imbalance between the extensor tendons that straighten the toe and the flexor tendons that bend the toes. This tendon imbalance can result in a progressive claw toe deformity. […] Inflammatory conditions such as rheumatoid arthritis, gout, systemic lupus, exanthematous disease, and Reiter’s disease may cause synovitis of the joints, and result in stretching or laxity of joint ligaments which allows the deformity to develop.

• #1 Understanding Hammertoes: Causes, Symptoms, and Treatment Options

  https://www.webmd.com/a-to-z-guides/understanding-hammertoes-basics

  Hammertoes can be a serious problem in people with diabetes or poor circulation because they have a higher risk for infections and foot ulcers. […] If your hammertoe is severe, you may have surgery to correct it. It may be an option if your pain has gotten very bad, your toe is very rigid, or you have an open sore because of your hammertoe. […] Hammertoe is a common problem that causes one or more of your toes to curl upward at the middle joint. You can reduce your risk for hammertoe by avoiding tight shoes and high heels, but some people can develop this condition simply by having high arches or flat feet. Certain medical conditions can increase your risk, too.

• #1 Hammertoe and mallet toe – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hammertoe-and-mallet-toe/symptoms-causes/syc-20350839

  Hammertoe and mallet toe are foot problems that cause a bend in a toe or toes. Wearing shoes that don’t fit well can cause hammertoe and mallet toe. Other causes are foot injury and certain illnesses, such as diabetes. Often the cause isn’t known. […] A hammertoe has an unusual bend in the middle joint of a toe. Mallet toe has a bend in the joint nearest the toenail. […] Hammertoe and mallet toe have been linked to: […] Imbalance of the toe muscles. If the muscles aren’t balanced, they can put pressure on the tendons and joints. This imbalance can lead to hammertoe and mallet toe over time. […] For a while, the toe still might be able to unbend. But over time, the tendons and joints of a hammertoe or mallet toe might tighten. This can cause the toe to stay bent.

• #1 4 Bothersome Hammertoe Symptoms: Chicagoland Foot and Ankle: Board Certified Foot and Ankle Specialists and Surgeons

  https://www.chicagolandfootandankle.com/blog/4-bothersome-hammertoe-symptoms

  A hammertoe (also called a mallet toe) is a condition that results in an unnatural bend in one or both joints of an affected toe. It is often related to an imbalance in the ligaments, tendons, or muscles that bend your toe and keep it straight. The condition causes the toe to become rigid and stiff in a curled position. […] Hammertoe is a progressive condition that typically begins as a mild deformity, but becomes more severe without treatment. […] A hammertoe can result in improper distribution of your body weight, causing unnatural pressure or wear-and-tear on other parts of your foot and body. […] Because a hammertoe forces your foot to bend at an abnormal angle, the weight and stress are unnaturally distributed. […] Hammertoe surgery restores normal alignment to the affected toe with techniques like bone fusions, joint resections, or tendon transfers.

• #1 Hammer, Claw, and Mallet Toes | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/hammer-claw-and-mallet-toes-hw143427

  Tight shoes are the most common cause of these toe problems. Wearing tight shoes can cause the toe muscles to get out of balance. If a shoe forces a toe to stay in a bent position for too long, the muscles tighten and the tendons shorten, or contract. This makes it harder to straighten the toe. Over time, the toe muscles can’t straighten the toe, even when you aren’t wearing shoes. […] These toe problems form over years and are common in adults. Women are affected more often than men because they are more likely to wear shoes with narrow toes or high heels. […] Less often, these toe problems are linked with other conditions, such as diabetes, rheumatoid arthritis, stroke, or an injury to the foot or ankle. […] You may need surgery if other treatments don’t control your pain, if your toe limits activity, or if you can’t move the toe joint (fixed toe problem). In general, surgery is used only for severe toe problems.

• #1 Hammertoe and Mallet Toe | Alliance Foot & Ankle Specialists

  https://www.footdoc.org/blog/hammertoe-and-mallet-toe.cfm

  Hammertoe and mallet toe are deformities of the toes that can be due to a variety of factors. […] They both can be caused by the following: Muscle or tendon imbalance, Structure of the foot, Trauma or injury to the foot or toes, Shoes that do not fit properly or have a high heel, Nerve damage. […] The most obvious signs that you have hammertoe or mallet toe is being unable to straighten your toe. This can cause problems such as: Pain when wearing shoes, Problems with balance, Tripping, Blisters, corns, and calluses. […] An experienced podiatrist can diagnose both hammertoe and mallet toe. To diagnose either condition, a physical exam will be done and imaging tests may be ordered to evaluate the bones and joints of your toes and feet. […] Once a diagnosis is made, treatment options will be recommended by your podiatrist based on the severity of your condition. Treatments for both conditions are similar and focus on managing pain and other symptoms. Some options are: Change in footwear, Custom orthotics, Padding, Medication, Exercises, Surgery. […] Surgery may be an option to correct hammertoe and mallet toe if other options do not provide relief.

• #1 Hammer, Claw or Mallet Toe | CommonSpirit Health

  https://www.commonspirit.org/conditions-treatments/hammer-claw-or-mallet-toe

  Hammer, claw, and mallet toes are toes that are bent into an odd position. […] A hammer toe bends down toward the floor at the middle toe joint. This causes the middle toe joint to rise up. It usually affects the second toe. […] A mallet toe bends down at the joint closest to the tip of the toe. It often affects the second toe, but it may happen in the other toes too. […] During the physical exam, your doctor will look at your foot to see if the toe joint is fixed or flexible. A joint that has some movement can sometimes be straightened without surgery. A fixed joint often requires surgery. […] You may need surgery if other treatments don’t control your pain, if your toe limits activity, or if you can’t move the toe joint (fixed toe problem). In general, surgery is used only for severe toe problems.

• #1 Hammer Toes, Mallet Toes and Claw Toes

  https://keystonehealth.org/blog/hammer-toes-mallet-toes-and-claw-toes/

  A hammer toe is the contracture or bending of the middle joint of your toe. A mallet toe is the contracture or bending of the joint closest to the tip of the toe. A claw toe is the bending upwards of the joint at the base of the toe with the middle toe joint bent down. […] The most common cause of these toe deformities is a muscle or tendon imbalance. This imbalance results in the mechanical or structural change in the toe over time. Typically, hammertoes are chronic and get worse with time. […] Good, supportive shoe wear with adequate toe box room can help. Some hammertoes are hereditary and cannot be prevented but can be slowed. Certain types of shoe gear can aggravate these conditions and progress them faster. […] We start with weightbearing x-rays so we can see what the toes look like with the tendons firing. We will also inspect your bones, joints and alignments. This will let us determine the best treatment for you and how we can slow down the progressiveness of the deformity. […] These conditions get worse over time, so if we can slow the progression, we can hopefully avoid the need for surgical intervention in the future.

• #1 A Guide to Hammertoe and Mallet Toe – WWMG Blog

  https://www.wwmedgroup.com/guide-to-hammertoe-mallet-toe/

  Hammertoe and mallet toe are foot issues that cause a bend in a toe or multiple toes. Hammertoe is a bend in the second, or middle, joint of the toe. Mallet toe is a bend in the third joint of the toe, closest to the toenail. These conditions often result from an imbalance in the ligaments that hold the toes in proper alignment. […] Women are more likely to develop hammertoe or mallet toe than are men, often because they wear shoes with higher heels. Additionally, patients with diabetes or rheumatoid arthritis are at higher risk of developing foot conditions. […] Its important to note that hammertoe and mallet toe may worsen if left untreated. Seeking medical advice from a WWMG Podiatrist can help you find effective options for treatment. […] The severity of hammertoe and mallet toe can vary for each patient, but identifying the issue early is important in order to avoid surgery. […] The severity of the foot condition will determine if surgery is needed. Severe or rigid toe joint deformities may not respond to conservative therapies. Some patients will need surgery to restore proper alignment in the toe joints.

• #1 Hammertoe

  https://www.foothealthfacts.org/conditions/hammertoe

  Hammertoe is a contracture (bending) deformity of one or both joints of the second, third, fourth or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop. […] The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) or neurological changes in the foot that occur over time in some people. […] Hammertoes are progressive they do not go away by themselves and usually they will get worse over time. However, not all cases are alike some hammertoes progress more rapidly than others. […] In some cases, usually when the hammertoe has become more rigid and painful or when an open sore has developed, surgery is needed.

• #1 Hammertoes | University Foot & Ankle Institute

  https://www.footankleinstitute.com/conditions/hammer-toe

  Hammertoe deformities occur due to an imbalance in the muscles, tendons, or ligaments that are responsible for holding the toe straight. […] The hammertoe deformity manifests as an abnormal bend in the middle joint of a toe. The deformity can be triggered or made worse by the type of shoes you wear, foot structure, trauma, and certain disease conditions. […] The hammertoe may, at first, remain flexible and may not cause any significant issues. Over time, however, the flexibility lessens and the tendons of the toe contract and tighten. This will cause the toe to bend permanently, causing mobility issues and pain. […] If a hammertoe deformity is addressed at the onset with the right conservative treatment, it can be reversed to an extent. Some treatment options include: […] Physical therapy to help strengthen the foot and toe. This helps correct the muscle, tendon and ligament imbalances that have formed and prevent the deformity from reforming. […] Genetics is a top cause of hammertoe. Other causes include those with bunions or diseases such as rheumatoid arthritis, diabetes, or neuromuscular disease.

• #1 What is a Hammertoe? – Florida Foot and AnkleVisit our FacebookVisit our InstagramVisit our TwitterVisit our FacebookVisit our InstagramVisit our Twittercloseclock-omap-markerchevron-downphonebarslocation-arrowlinkedinfacebookpinterestyoutubersstwitterins

  https://flafootandankle.com/what-is-a-hammertoe/

  Exercises to help stretch and strengthen the tendons around the toe can enable hammertoe from progressing further. […] For severe cases where conservative methods have failed to stretch out the toe, surgery is an option to flatten a hammertoe. […] Foot and ankle surgeons can use different techniques depending upon the severity of the hammertoe. Options include fusion of the toe, a tendon transfer, or joint resection.

• #1 Hammertoe Repair – Medical Clinical Policy Bulletins | Aetna

  https://www.aetna.com/cpb/medical/data/600_699/0636.html

  Initially, hammertoes are flexible and can be corrected with simple measures but, if left untreated, they can become fixed and require surgery. […] The actual procedure will depend on the type and extent of the deformity. […] Many different procedures have been described in the literature for the correction of hammertoe deformity. […] Surgical procedures utilized for the correction of hammer toe include, but may not be limited to, amputation for severe deformity, arthrodesis, arthroplasty, flexor to extensor tendon transfer, partial or total phalangectomy or tenotomy. […] Implants have been developed to stabilize the PIP joint, purportedly to promote fusion. […] The authors concluded that the CannuLink intramedullary device for hammertoe correction resulted in fewer complications, only 1 recurrent deformity, and no re-operations compared with K-wire fixation.

• #1 Hammertoe Vs. Mallet Toe Vs. Claw Toe: What’s the Difference? – Chelsea Foot and Ankle

  https://www.chelseafootandankle.com/blog/hammertoe-vs-mallet-toe-vs-claw-toe-whats-the-difference/

  In advanced cases, surgery is usually the best approach. Your surgeon may opt for one of the two following hammertoe surgery methods: Joint resection The surgeon cuts the constricted ligaments and tendons to release the joint and removes a small portion of the bone to straighten it. This method may require a temporary pin to be put in place to prevent the toe from moving. […] Fusion The surgeon will perform a joint resection and remove the ends of the bones to prepare them to grow together or fuse. Pins are also used to keep the joint stable after surgery and then are removed once the fusion process is complete.

• #1 Hammertoe and Corns: Diagnosis and Treatment in Brooklyn | NYCAccessibility ToolsIncrease TextDecrease TextGrayscaleHigh ContrastNegative ContrastLight BackgroundLinks UnderlineReadable FontReset

  https://bestfootdoctorny.com/hammertoe-and-corns-diagnosis-and-treatment/

  Knowing and understanding what caused your hammertoe is key to treating it. […] The procedure to fix a hammertoe is called arthroplasty. This procedure involves shaving down the head of the phalanx (bone spur) to straighten the toe. The surgery will also eliminate the painful corn caused by the pressure between the shoe and the bone spur inside.

• #1 Surgery for Hammer Toe | Annapolis Hammer Toe Podiatrist | Annapolis Foot & Ankle Center

  https://www.annapolisfootandanklecenter.com/faqs/surgery-for-hammertoe-board-certified-surgeons-in-maryland.cfm

  Without early treatment, hammer toe usually worsens. The muscles and tendons stay tight, and the toe becomes rigid and fixed in its bent position. Now the toe is in a state of permanent contracture. […] Surgery is likely necessary for relief if your toe is stiff and causing pain. There are several types of hammer toe surgery. […] The most common surgery for flexible hammer toe is straightening the toe with a tendon transfer. This procedure involves rerouting tendons to maneuver the bent joint back into a straight position. […] In this case, we may recommend a joint resection or a bone fusion. During a joint resection, part of your bone is removed to allow your toe to return to its normal position. In a fusion, the toe is straightened, and the bones are fused together, preventing the toe from bending.

• #1 Hammer Toe Surgery to Correct Mallet Toe | Pete Smith, DPM

  https://ankleandfootcenters.com/hammer-toe-surgery/

  The type of hammertoe surgery depends on the specifics of the patient’s condition. There are generally three types of procedures: tendon transfer, joint resection (arthroplasty), and fusion (arthrodesis). Each type of surgery has its pros and cons, and the choice depends on factors like the severity of the deformity, the patient’s age, and overall health status. […] As with any surgical procedure, hammertoe correction surgery carries some risks. These may include infection, bleeding, nerve damage, or adverse reactions to anesthesia. There’s also the possibility that the surgery may not fully correct the deformity, or the hammertoe could recur. Furthermore, some patients may experience stiffness in the toe or a change in the balance of their foot, which can affect gait. It’s crucial to discuss these potential risks and complications with the surgeon before deciding on surgery.

• #2 Hammertoe Deformity: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1235341-overview

  Hammertoe deformity is the most common deformity of the lesser toes. The fundamental problem is a chronic, sustained imbalance between flexion and extension forces applied to the lesser toes. […] Hammertoe deformity primarily involves flexion deformity of the PIP joint of the toe, with hyperextension of the MTP and DIP joints. […] When the second ray of the foot is longer than the first and shoewear is improperly fitted, flexion of the PIP joint occurs to accommodate the shoe. This length difference also causes MTP synovitis to develop from overuse of the second MTP joint. […] With all three of these etiologies, the EDL tendon gradually loses mechanical advantage at the PIP joint, as does the FDL tendon at the MTP joint. The intrinsic muscles subluxate dorsally as the MTP hyperextends. They now extend the MTP joint and flex the PIP joint, as opposed to their usual functions of flexing the MTP joint and extending the PIP joint.

• #2

  http://www.bofas.org.uk/hyperbook/forefoot/lesser-toe-deformities

  Hammer toe is defined as a primary flexion deformity of the PIPJ, with or without hyperextension at the MTPJ, but with a neutral or hyperextended DIPJ. […] The pull of the extensor tendons is mainly transmitted to the MTPJ via the extensor sling. The extensors are therefore unable to correct the PIPJ deformity, but hyperextension may occur at the MTPJ instead. This may progress to MTPJ instability as the plantar plate becomes attenuated. […] For fixed PIPJ deformities the PIPJ is excised or fused. […] The DIPJ flexion deformity may occur due to direct pressure from the shoe and eventually the FDL tightens resulting in a fixed deformity. […] A fixed deformity is treated by excision of the DIPJ and fusion.

• #2 Hammertoe and mallet toe – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hammertoe-and-mallet-toe/symptoms-causes/syc-20350839

  Hammertoe and mallet toe are foot problems that cause a bend in a toe or toes. Wearing shoes that don’t fit well can cause hammertoe and mallet toe. Other causes are foot injury and certain illnesses, such as diabetes. Often the cause isn’t known. […] A hammertoe has an unusual bend in the middle joint of a toe. Mallet toe has a bend in the joint nearest the toenail. […] Hammertoe and mallet toe have been linked to: […] Imbalance of the toe muscles. If the muscles aren’t balanced, they can put pressure on the tendons and joints. This imbalance can lead to hammertoe and mallet toe over time. […] For a while, the toe still might be able to unbend. But over time, the tendons and joints of a hammertoe or mallet toe might tighten. This can cause the toe to stay bent.

• #2 Hammertoes: What It Is, Causes, Relief & Treatment

  https://my.clevelandclinic.org/health/diseases/17038-hammertoes

  Hammertoes happen when something puts pressure on your toes and pushes them out of place. Over time, muscles and tendons in your toes tighten, freezing your toes in a curled shape. Hammertoes develop when something pushes your toes out of their natural position for a long time. Hammertoes happen when something pushes your toes out of position for a long time. Eventually, the muscles and tendons in your feet and toes adjust to the unusual, cramped position and tighten up. If that extra pressure lasts long enough, your muscles and tendons may tighten so much you cant move your toes out of the curled position. The main causes of hammertoes include: Wearing poorly-fitting shoes: Shoes that are too narrow (have a small toe box) or dont have enough arch support can force your toes into unnatural positions. People who wear high heels and kids who keep wearing shoes theyve outgrown may develop hammertoes. Having high arch feet or flat feet: Your foots natural shape may make you more likely to develop hammertoes. Having long toes: If your toes are naturally longer than usual, they may not have enough room in common shoe widths or sizes. This can put extra pressure on them and cause hammertoes. Certain health conditions: Any condition that affects your feet and toes can cause hammertoes. People with diabetes or rheumatoid arthritis may have an increased risk. Bunions: Bunions can push your toes out of alignment and put extra pressure on them.

• #2 A Guide to Hammertoe and Mallet Toe – WWMG Blog

  https://www.wwmedgroup.com/guide-to-hammertoe-mallet-toe/

  Hammertoe and mallet toe are foot issues that cause a bend in a toe or multiple toes. Hammertoe is a bend in the second, or middle, joint of the toe. Mallet toe is a bend in the third joint of the toe, closest to the toenail. These conditions often result from an imbalance in the ligaments that hold the toes in proper alignment. […] Women are more likely to develop hammertoe or mallet toe than are men, often because they wear shoes with higher heels. Additionally, patients with diabetes or rheumatoid arthritis are at higher risk of developing foot conditions. […] Its important to note that hammertoe and mallet toe may worsen if left untreated. Seeking medical advice from a WWMG Podiatrist can help you find effective options for treatment. […] The severity of hammertoe and mallet toe can vary for each patient, but identifying the issue early is important in order to avoid surgery. […] The severity of the foot condition will determine if surgery is needed. Severe or rigid toe joint deformities may not respond to conservative therapies. Some patients will need surgery to restore proper alignment in the toe joints.

• #2 Hammer Toes | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/117049/all/Hammer_Toes?q=Arthritis

  Contraction deformities of the toes […] Hammer toe (as defined) involves a plantar flexion deformity of the proximal interphalangeal (PIP) joint with varying degrees of hyperextension of the metatarsophalangeal (MTP) and distal interphalangeal (DIP) joint, primarily in sagittal plane. […] Flexor stabilization (most common cause and occurs in pronated foot/foot with pes planus). The flexor digitorum longus (FDL) muscle remains overactive, overusing the toes to assist in relative foot instability. […] Biomechanical dysfunction results in muscle/tendon imbalance between the EDL tendon at the PIP joint and the FDL tendon at the MTP joint; the imbalance at the MTP joint level leads to the altering of the stabilizing force of the intrinsic muscles inserting into the extensor sling and wing apparatus of the MTP joint. In the case of classic hammer toes, the toe(s) sublux dorsally as the MTP hyperextends. This results in plantar flexion of the PIP joint and hyperextension of the MTP joint. […] Specific pathomechanics vary by etiology: Toe length discrepancy or narrow footwear toe box induces PIP joint flexion by forcing digit to accommodate shoe. […] Damage to joint capsule, collateral ligaments, or synovia leads to unstable PIP joint or MTP joint.

• #2 Hammertoe – Premier Medical Group

  https://www.premiermedicalhv.com/divisions/services/hammertoe/

  Hammertoe typically begins as a mild deformity and grows progressively worse over time. The most common cause is a muscle/tendon imbalance, which can be aggravated by shoes that do not fit properly. If the toes forced into a cramped position, such as when a tight shoe is worn, or while wearing flip flops for extended periods, a hammertoe can gradually form. In some cases, the foot deformity is the result of an earlier toe trauma, such as stubbing, jamming, or breaking. Hammertoes may also be the result of corns and calluses that can reposition toes while inside the shoe. […] Aside from environmental causes, several factors can put you at a greater risk for developing toe deformities. Foot deformity risk increases with age, and women are far more likely to develop hammertoe than men. Diseases like arthritis and diabetes can also predispose a person to developing foot deformities, and heredity is also thought to play a role. The foots natural shape, too, can be a risk; those whose second toes are longer than the big toe are more at risk for developing this deformity.

• #2 Treat Hammer Toe, Mallet Toe, & Claw Toe in Commerce Twp, MI

  https://lakesfootankle.com/conditions/toe-deformities/lesser-digit-deformities/

  In the early stages of hammer, mallet, or claw toe, the joint may remain flexible. You might not have any noticeable pain or other symptoms getting in the way of daily life. As the condition progresses, however, the joint can become more rigid and stiff, cause more pain, and lead to calluses or sores. Eventually, even wearing shoes can become painful, and surgery may become necessary. […] Non-surgical claw toe treatments may include changing your footwear, wearing pads or custom orthotic inserts, and performing stretches and exercises to strengthen toe muscles and tendons. These conservative treatments can be highly effective if the toe is still flexible; however, if it becomes fixed and rigid, surgery may be required. […] Yes, it is possible to straighten a mallet toe without surgery, especially if you visit a podiatrist as soon as you notice symptoms. We can use measures like taping, physical therapy, custom orthotics, and more to encourage flexibility and strength in the affected joints.

• #2 What causes hammertoe and mallet toe? – Beaver Valley Foot Clinic

  https://bvfootclinic.com/what-causes-hammertoe-and-mallet-toe/

  Genetics: There is evidence to suggest that genetics can predispose individuals to certain foot deformities, including hammer toe and mallet toe. If a persons parents or other close relatives have had these conditions, they may be more likely to develop them as well. […] Foot Mechanics: Certain foot structures or biomechanical abnormalities, which can be inherited, may increase the risk of developing hammer toe and mallet toe. For example, having a high arch or flat foot can alter the distribution of weight on the foot and contribute to toe deformities. […] Yes, hammer toe and mallet toe can lead to other foot problems if left untreated. Some potential complications and related foot problems associated with hammer toe and mallet toe include: […] Corns and Calluses: The abnormal toe positions in hammer toe and mallet toe can cause friction and pressure against the inside of shoes, leading to the formation of corns and calluses. These can be painful and may require treatment to alleviate discomfort. […] Bursitis: Inflammation of the bursa, a fluid-filled sac that cushions and lubricates joints, can occur in the affected toes due to constant rubbing against shoes. This can cause pain, swelling, and redness in the affected area.

• #2 Hammer, Claw, and Mallet Toes | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/hammer-claw-and-mallet-toes-hw143427

  Tight shoes are the most common cause of these toe problems. Wearing tight shoes can cause the toe muscles to get out of balance. If a shoe forces a toe to stay in a bent position for too long, the muscles tighten and the tendons shorten, or contract. This makes it harder to straighten the toe. Over time, the toe muscles can’t straighten the toe, even when you aren’t wearing shoes. […] These toe problems form over years and are common in adults. Women are affected more often than men because they are more likely to wear shoes with narrow toes or high heels. […] Less often, these toe problems are linked with other conditions, such as diabetes, rheumatoid arthritis, stroke, or an injury to the foot or ankle. […] You may need surgery if other treatments don’t control your pain, if your toe limits activity, or if you can’t move the toe joint (fixed toe problem). In general, surgery is used only for severe toe problems.

• #2 Hammertoe Surgery – What to Expect With The Procedure

  https://www.jawspodiatry.com/hammertoe-surgery-expect/

  Hammertoes are caused by an abnormal bend in the toe as they always occur on the middle joints of the lesser toes. […] If untreated surgically, they worsen and are known to be extremely painful. […] While both a hammertoe and mallet toe usually occur in the second, third and fourth toes, their main difference lies in the location of the bend. […] Other causes include: genetics (flat, flexible feet and high arches); foot injury (stubbed, jammed or broken toes) and certain illnesses, such as rheumatoid arthritis and diabetes. […] The affected digit may be able to remain unbent for a while, but it is likely that the tendons and joints will tighten over the course of time. […] Surgical correction is usually performed on the middle joint. […] The bone is removed and surrounding ligaments adjusted. […] Two other surgical possibilities include: Tendon Transfer and Joint Resection. […] A common risk is the possibility of your hammertoe recurring, but at the same time, this minimally invasive procedure reduces the risk of infections, improves the appearance of the toe and increases success rates.

• #2 Hammer toe – Wikipedia

  https://en.wikipedia.org/wiki/Hammer_toe

  A hammertoe or contracted toe is a deformity of the muscles and ligaments of the proximal interphalangeal joint of the second, third, fourth, or fifth toe, bending it into a shape resembling a hammer. […] Hammertoes and clawtoes have multiple causes. Hammer toe most frequently results from wearing poorly fitting shoes that can force the toe into a bent position, such as 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. […] The toe muscles work in pairs; if the muscles pulling in one direction are much weaker than those pulling in the other direction, the imbalance can bend the toe. If the bend persists, then as the tendons and ligaments tighten, the bend may become permanent. […] Toe deformities can also be caused by muscle, nerve, or joint damage, resulting from conditions such as osteoarthritis, rheumatoid arthritis, stroke, Charcot-Marie-Tooth disease, complex regional pain syndrome or diabetes.

• #2 What Causes Hammertoe: Types, Diagnosis, Treatment

  https://www.verywellhealth.com/hammertoe-5216177

  Diabetes (the body’s inability to regulate blood sugar) can lead to hammertoe because it increases the risk for infection and foot ulcers. […] Post-polio syndrome, a condition that strikes years or even decades after a person has recovered from polio, can sometimes cause problems with the feet. […] Hammertoe can run in families. While a curled toe isn’t necessarily hereditary, foot shape can be passed down through generations. […] Flat feet is a condition in which one or both feet have little or no arch. It is a risk factor for hammertoe. In people with flat feet, there is pressure on the toes when the foot tries to compensate for a lack or reduced arch.

• #2 Hammertoe – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559268/

  Hammertoes are among the most common deformities of the forefoot. […] Hammertoe is a deformity that involves flexion at the interphalangeal joints (IPJ) and can be distinguished into categories including the classic hammertoe, mallet toe or claw toe. […] It results from an imbalance between the weak intrinsic muscles and the stronger extrinsic muscles surrounding the metatarsophalangeal joints (MTPJ) of the lesser digits. […] The causes of hammertoe deformity are many and multifactorial, including congenital and acquired, with the most accepted factor and component being a biomechanical dysfunction. […] The etiology of deformities of the lesser digits includes: Neuromuscular conditions, Diabetes, Inflammatory arthropathies, Ill-fitting shoes and high heels, Intrinsic muscle imbalance, Hallux valgus, Long metatarsals, Pes planus.

• #2 The pathology and management of lesser toe deformities

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5367573/

  These deformities may occur as a result of an imbalance between the forces of extension and flexion about the relevant joints. […] The DIPJ deformity in the mallet toes is often attributed to tightness in shoes. Initially the DIPJ flexes due to direct pressure from the shoe but eventually the FDL tightens, causing a persistent deformity. This may be associated with callosities on the tip of the toe and pressure on the nail. The mallet deformity is flexible in the early stages, but as the collaterals and capsule tighten the deformity becomes fixed. […] In a hammer toe, the first deformity is at the PIPJ. This occurs in a similar manner to the mallet toe. It is often seen in the fifth and sixth decades of life and is associated with hallux valgus and inflammatory arthritis. Although footwear plays a significant role in its development, trauma can result in an acute rupture of the central slip of the extensor tendon which may cause the deformity.

• #2 Understanding Hammertoes: Causes, Symptoms, and Treatment Options

  https://www.webmd.com/a-to-z-guides/understanding-hammertoes-basics

  A hammertoe happens when the muscles and ligaments around your toe joint get out of balance. This makes the middle joint of your toe curve upward and get stuck in this position. […] The muscles of each toe work in pairs. When the toe muscles get out of balance, a hammertoe can form. Muscle imbalance puts a lot of pressure on your toe’s tendons and joints. This pressure forces your toe into a hammerhead shape. […] Causes include: Shoes that dont fit. If your shoes are too tight or too small, they push your toes out of balance. […] Wearing high heels. Pointy, high-heeled footwear squishes your toes and smushes them into the front of the shoe. That severe pressure on the toes can cause hammertoe and other problems. […] Having high arches or flat feet. Both can set the stage for hammertoe.

• #2

  https://www.orthobullets.com/foot-and-ankle/7014/hammer-toe

  Hammer Toe is a lesser toe deformity characterized by PIP flexion, DIP extension and MTP slight extension. […] Diagnosis is made clinically with the presence of a rigid or flexible lesser toe with PIP flexion, DIP extension and MTP slight extension. […] Etiology includes pathoanatomy such as plantar plate injury, overpull of EDL, and imbalance of intrinsics. […] Associated conditions include painful corns at dorsal PIP joint.

• #2 Toe Deformities: Causes and Treatment | Doctor

  https://patient.info/doctor/toe-deformities

  Hammer toes are sagittal plane deformities of the lesser toes. […] A hammer toe shows extension of the MTP joints and the DIP joints. The PIP joints are hyperflexed. […] Toe deformities are caused by a variety of factors: […] Tendon imbalance. When the foot cannot function normally, the tendons may stretch or tighten to compensate, leading to toe deformities. […] When the toe deformity is painful or permanent, surgical repair is performed to relieve pain, correct the problem and provide a stable, functional toe. […] Type of surgery depends on whether the deformity is fixed or flexible. […] Correction of hammer toe using either joint resection arthroplasty, PIP arthrodesis without osteotomy, or interpositional implant arthroplasty are all common techniques that lead to adequate pain relief and correction of the deformity.

• #2 Hammer, Claw or Mallet Toe | CommonSpirit Health

  https://www.commonspirit.org/conditions-treatments/hammer-claw-or-mallet-toe

  For fixed toe problems, doctors often do surgery on the bones. One option is removing part of the toe bone. Another is removing part of the joint and letting the toe bones grow together. […] Flexible toe problems are often treated by moving tendons to release tension on the joint. This can let the toe straighten. In some cases, the surgery will still include work on the bones.

• #3 Hammer Toe Surgery to Correct Mallet Toe | Pete Smith, DPM

  https://ankleandfootcenters.com/hammer-toe-surgery/

  Hammertoe and mallet toe can result from several causes. In many cases, wearing shoes that are too tight, too short, or high-heeled can force the toes into a bent position, leading to these deformities over time. Other causes may include muscle imbalances or nerve damage that affects the muscles of the toes. Some people are more prone to these conditions due to genetic predisposition or underlying medical conditions, such as arthritis or diabetes. […] Hammertoe surgery is typically considered when non-surgical treatments fail to relieve symptoms, or if the toe has become rigid and immovable. The decision for surgery is also influenced by factors such as the severity of the deformity, the level of pain or discomfort experienced, and the impact of the condition on a person’s daily activities. Medical professionals will evaluate the patient’s overall health, age, and lifestyle before recommending surgery.

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