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June 26 2015

badtact727

Hammer Toe Straightening Surgery

HammertoeOverview

Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with changes in shoe styles and foot care products. But if left untreated, hammertoes can become hammertoe more rigid and painful. Corns are more likely to develop as time goes on-and corns never really go away, even after trimming. In more severe cases of hammertoes, corn lesions may evolve into severe ulcerations. These lesions frequently occur in patients who have vascular disease or are Diabetic with neuropathy. The ulcerations can extend to the bone and result in infection and possible loss of digit or amputation.

Causes

Hammertoe and mallet toe have been linked to certain shoes. High-heeled shoes or footwear that's too tight in the toe box can crowd your toes into a space that's not large enough for them to lie flat. This curled toe position may eventually persist even when you're barefoot. Trauma. An injury in which you stub, jam or break a toe may make it more likely for that digit to develop hammertoe or mallet toe. Nerve injuries or disorders. Hammertoe and mallet toe are more common in people who have nerve damage in their feet, which often occurs with such medical problems as a stroke or diabetes.

HammertoeSymptoms

The most obvious symptom of hammertoe is the bent, hammer-like or claw-like appearance of one or more of your toes. Typically, the proximal joint of a toe will be bending upward and the distal joint will be bending downward. In some cases, both joints may bend downward, causing the toes to curl under the foot. In the variation of mallet toe, only the distal joint bends downward. Other symptoms may include Pain and stiffness during movement of the toe, Painful corns on the tops of the toe or toes from rubbing against the top of the shoe's toe box, Painful calluses on the bottoms of the toe or toes, Pain on the bottom of the ball of the foot, Redness and swelling at the joints. If you have any of these symptoms, especially the hammer shape, pain or stiffness in a toe or toes, you should consider consulting your physician. Even if you're not significantly bothered by some of these symptoms, the severity of a hammertoe can become worse over time and should be treated as soon as possible. Up to a point hammertoes can be treated without surgery and should be taken care of before they pass that point. After that, surgery may be the only solution.

Diagnosis

Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.

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

Surgery is the approach that is often necessary to correct hammertoe that fails to respond to nonsurgical management. Surgery is appropriate when the muscles and tendons involved in a hammertoe problem have become so tight that the joints are rigid, misaligned and unmovable. There are a number of surgical techniques for dealing with the complex range of joint, bone, muscle, tendon and ligament abnormalities that define each hammertoe's make-up. To correct a hammertoe deformity, the surgeon's goal is to restore the normal alignment of the toe joint, relieving the pressure that led to the hammertoe's development (this should also relieve the pain, as well). To do this, he or she may remove part of the boney structure that creates a prominence at the top of the joint. Tighten or loosen the muscles, tendons and ligaments around the toe joints. Realign the toe bones by cutting one or more and shifting their position, realigning muscles, tendons and ligaments accordingly. Use screws, wires or plates to hold the joint surfaces together until they heal. Reconstruct a badly damaged joint or replace it with an artificial implant.
Tags: Hammer Toes
badtact727

Hammer Toe Caused By Rheumatoid Arthritis

HammertoeOverview

There are two main types of Hammer toe. Hammertoes can be flexible, which means that you can still move the toe a bit - these are easier to treat with stretching, wider shoes and in some cases, toe splints. Rigid hammertoes occur when the foot condition has persisted for so long without treatment that the tendons become too rigid to be stretched back to normal. Rigid hammertoes are more common in people with arthritis. This foot condition usually needs to be treated with surgery.

Causes

If a foot is flat (pes planus, pronated), the flexor muscles on the bottom of the foot can overpower the others because a flatfoot is longer than a foot with a normal arch. When the foot flattens and lengthens, greater than normal tension is exerted on the flexor muscles in the toes. The toes are not strong enough to resist this tension and they may be overpowered, resulting in a contracture of the toe, or a bending down of the toe at the first toe joint (the proximal interphalangeal joint) which results in a hammertoe. If a foot has a high arch (pes cavus, supinated), the extensor muscles on the top of the foot can overpower the muscles on the bottom of the foot because the high arch weakens the flexor muscles. This allows the extensor muscles to exert greater than normal tension on the toes. The toes are not strong enough to resist this tension and they may be overpowered, resulting in a contracture of the toe, or a bending down of the toe at the first toe joint (the proximal interphalangeal joint) which results in a hammertoe.

HammertoeSymptoms

Pain upon pressure at the top of the bent toe from footwear. The formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe.

Diagnosis

The treatment options vary with the type and severity of each hammer toe, although identifying the deformity early in its development is important to avoid surgery. Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.

Non Surgical Treatment

There is a variety of treatment options for hammertoe. The treatment your foot and ankle surgeon selects will depend upon hammertoes the severity of your hammertoe and other factors. A number of non-surgical measures can be undertaken. Padding corns and calluses. Your foot and ankle surgeon can provide or prescribe pads designed to shield corns from irritation. If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult your surgeon about this option. Changes in shoewear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels, conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toe box and heels no higher than two inches. Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance. Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe. Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. Splinting/strapping. Splints or small straps may be applied by the surgeon to realign the bent toe.

Surgical Treatment

If your toe is not bendable, your doctor may recommend surgery. The type of surgery that will be performed will depend on the severity of the condition. You should expect blood and urine studies before the procedure, as well as x-rays of your feet. Your doctor will inject either a local or regional anesthetic. If your toe has some flexibility, the doctor may be able to straighten it by simply making an incision in the toe to release or lengthen the tendon. If the toe is not flexible, your doctor will probably make the same incision to release the tendon, but he or she may also remove some pieces of the bone so that the bone can be straightened. A k-wire is placed in the toe to help hold it straight while it is healing. This is taken out after about four weeks.
Tags: Hammer Toe
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