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Agos/17/2015 

Hammer ToeOverview


hammertoe, Claw and Mallet Toe are similar conditions, all caused by deformity of the toe joints. They usually develop slowly from wearing poor fitting shoes, but can also be due to muscle or nerve damage. Muscle imbalance causes the toes to bend into odd positions which can be extremely painful, limiting walking and activity. They become more common with aging and affect approximately 10-15% of the population. Women are five times more likely to suffer from hammertoe hammer, claw or mallet toe than men.


Causes


Factors that may increase you risk of hammertoe and mallet toe include age. The risk of hammertoe and mallet toe increases with age. Your sex. Women are much more likely to develop hammertoe or mallet toe than are men. Toe length. If your second toe is longer than your big toe, it's at higher risk of hammertoe or mallet toe.


HammertoeSymptoms


A hammer toe may be painful, especially when irritated by a shoe. All four toe conditions may cause cramps in the toes, foot and leg due to the abnormal function of the tendons in the foot. If a mallet toe has occurred, you are likely to suffer from a corn at the end of the toe. A hammertoe may cause a corn on the top of the toe. Infections and ulcers can also occur. In severe cases a mallet toe, trigger toe, claw toe or a hammer toe may create a downward pressure on the foot, which can result in hard skin and corns on the soles of the feet.


Diagnosis


Hammer toes may be easily detected through observation. The malformation of the person's toes begin as mild distortions, yet may worsen over time - especially if the factors causing the hammer toes are not eased or removed. If the condition is paid attention to early enough, the person's toes may not be permanently damaged and may be treated without having to receive surgical intervention. If the person's toes remain untreated for too long, however the muscles within the toes might stiffen even more and will require invasive procedures to correct the deformity.


Non Surgical Treatment


A toe doctor can provide you with devices such as hammer toe regulators or straighteners. These are also available for purchase locally. Another good idea is to start the hammer toe rehabilitation process by gently trying to straighten the joint and moving and flexing the affected toe as much as possible without straining it. If hammer toe taping doesn?t work, you may require surgery. If the joints and tendons have stiffened to a point of non-movement, hammer toe corrective surgery may need to enter the toe and either cut or manually move some of the tendons and ligaments. Although the treatment is relatively safe fast, you may deal with some stiffness afterwards.


Surgical Treatment


Probably the most frequent procedure performed is one called a Post or an Arthroplasty. In this case a small piece of bone is removed from the joint to straighten the toe. The toe is shortened somewhat, but there is still motion within the toe post-operatively. In other cases, an Arthrodesis is performed. This involves fusing the abnormally-contracted joint. The Taylor procedure fuses only the first joint in the toe, whereas the Lambrinudi procedure fuses both joints within the toe. Toes which have had these procedures are usually perfectly straight, but they take longer to heal and don't bend afterwards. A Hibbs procedure is a transfer of the toe's long extensor tendon to the top of the metatarsal bone. The idea of this procedure is to remove the deforming cause of the hammertoes (in this case, extensor substitution), but to preserve the tendon's function in dorsifexing the foot by reattaching it to the metatarsals. Fortunately, the Gotch (or Gotch and Kreuz) procedure--the removal of the base of the toe where it attaches to the foot, is done less frequently than in years past. The problem with this procedure is that it doesn't address the problem at the level of the deformity, and it causes the toe to become destabilized, often resulting in a toe that has contracted up and back onto the top of the foot. You can even have an Implant Arthroplasty procedure, where a small, false joint is inserted into place. There are several other procedures, as well.


HammertoePrevention


wear sensible shoes. Here are some tips. Most people have one foot that's bigger than the other. Fit your shoes to the bigger foot. Buy your shoes at the end of the day as your feet tend to swell a bit and you will get a better sense of fit. When you buy your shoes, wear the sock that you will be using when wearing that shoe - wear a sports sock when buyingtrainers, for example. As you get older, your feet get bigger. Get your feet measured every time you buy shoes. Don't go by shoe sizes. Shoe sizes vary among manufacturers; a shoe is the right size only when it fits comfortably. The ball of your foot should fit into the widest part of the shoe. A shoe should be sturdy so that it only bends in the ball of the foot, exactly where your big toes bend. Any shoe that can be bent anywhere along the sole or twisted side to side is generally too flimsy. There should be at least 1.5 cm between the tip of your longest toe and the front of the shoe. Never buy shoes that feel tight and expect them to stretch with wearing. If you have prominent areas on your feet such as hammer toes and bunions, avoid shoes with a lot of stitching or multiple pieces of fabric, as these stitched areas tend not to stretch to accommodate various toe deformities. Your shoes shouldn't ride up and down on your heel as you walk. The higher the heel, the less safe the shoe. Check children's shoes regularly.
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Jun/09/2015 

Overview
Bunions Hard Skin Bunions involve boney prominences and repositioning of the joints at the base of the big toes. Bunions most commonly affect the inner foot at the base of the big toe but also can affect the outside of the foot at the base of the little toe, referred to as a bunionette or tailor's bunion. Bunions most commonly affect women. Bunions may or may not cause symptoms. Treatment of bunions can include rest, icing, alteration offootwear, foot supports (orthotics), medications, steroid injections, and or surgery.

Causes
Although bunions tend to run in families, it is the foot type that is passed down-not the bunion. Parents who suffer from poor foot mechanics can pass their problematic foot type on to their children, who in turn are prone to developing bunions. The abnormal functioning caused by this faulty foot development can lead to pressure being exerted on and within the foot, often resulting in bone and joint deformities such as bunions and hammertoes.

Symptoms
If a foot bunion is developing, you may experience some of these symptoms. Bulge or bump on the outside of the base of your big toe. Swelling. Redness. Soreness. Thickening of the skin in that location. Corns or calluses. Limited movement of your big toe. Persistent or periodic pain. The pain you experience may be mild or severe. It may become increasingly difficult to walk in your normal shoes. The pressure on your other toes can cause your toenails to grow inward or your smaller toes to become bent.

Diagnosis
Your doctor can identify a bunion by examining your foot. Watching your big toe as you move it up and down will help your doctor determine if your range of motion is limited. Your doctor will also look for redness or swelling. After the physical exam, an X-ray of your foot can help your doctor identify the cause of the bunion and rate its severity.

Non Surgical Treatment
Treatment options are based on the severity of the deformity and symptoms. Nonsurgical treatments usually are enough to relieve the pain and pressure on the big toe. Your doctor may tell you to start wearing roomy, comfortable shoes and use toe padding or a special corrective device that slips into your shoes to push the big toe back into its proper position. To help relieve pain, you can take over-the-counter medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin and others). Whirlpool baths also may help to ease discomfort. Bunions

Surgical Treatment
The most simple procedure is reducing the bump, and while there will be a little pain and swelling afterwards and your mobility will be restricted, the recovery time is short (ie a few weeks), but it may not fix the underlying cause. More serious ops might involve lasers, robots, cutting bone in the foot and trying to reposition it, and/or inserting pins or wires. It can take months to recover fully and you might need a cast. Mike O?Neill recommends seeking an NHS consultant surgeon who specialises in bunion removal to ensure the best possible outcome. The type of anaesthetic, local or general, will depend on the procedure, but most are day cases and the surgery will take from less than 30 minutes to a couple of hours. Waiting times vary but from your first outpatient appointment to the op would be a minimum of a few months. Private treatment (preferably by an NHS consultant surgeon) is likely to cost thousands of pounds. A new less, invasive procedure called surgical correction of hallux valgus that makes a small incision in the bone has recently been approved for use in the NHS but there is still no conclusive evidence on how effective it is and it is not widely available.

Prevention
The best way to reduce your chances of developing bunions is to wear shoes that fit properly. Shoes that are too tight or have high heels can force your toes together. Bunions are rare in populations that don?t wear shoes. Make sure your shoes are the correct size and that there's enough room to move your toes freely. It's best to avoid wearing shoes with high heels or pointed toes.
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