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| GALLUZZO FOOT
& ANKLE CLINIC |
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| Hammertoes/ Corns |
A hammertoe is a bent or contracted toe. The contracture
is caused from an imbalance in the tendon or joint. Usually the
toes lie flat on the ground, only bending during certain points
while walking. The toe functions to decrease the pressure on the
ball of the foot by assisting the foot in pushing off the ground
during walking and running. There are tendons which insert into
the top and bottom of the toes which make them bend up or down.
If one set of tendons is more agressive than the other or is used
excessively due to an imbalance, the result is a buckling and bending
of the toe. Over time this can lead to a permanent contraction of
the tendon and later, contracture of the toe causing corns to develop. |
Picture of hammertoes |
Picture
of different types of hammertoes |
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If the bent position of the toe can still be manually
straightened out, the deformity is called a flexible hammer toe.
When the contracture cannot be manually straightened out and involves
a bone problem, it is called a rigid hammer toe. There are 3 bones
that comprise the smaller toes. A contracture at the distal joint
(furthest from the foot) is called a mallet toe. When both joints
are contracted the deformity is called a claw toe.
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Conservative treatment
is directed at reducing the pressure on the contracted toe
by the use of gel-impregnated padding, toe-strappings, and
orthotics. |
Corns
(increased amount of built up skin) occur as a result of pressure
between a bony prominence in the toe, rubbing or pressing against
something else, such as the overlying
shoe or an adjacent toe. As the
corn thickens, it produces irritation in the underlying tissue
which may or may not involve the bony structures
of the toe and becomes swollen and painful.
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EARLY
TREATMENT-CONSERVATIVE APPROACH
Early treatment is directed at decreasing the pressure on the
contracted toe. This can be achieved by use of a lower heel height,
deeper toe box shoe or tennis shoe, trimming down the corn, or
accommodative padding. Sometimes functional orthotics may help
the foot work more efficiently and reestablish the balance of
tendons, lessening the tendency toward hammer toe contracture.
SURGICAL TREATMENT
When conservative care does not relieve a painful deformity,
surgery is recommended.This may involve a tendon lengthening,
and/or removing a small portion of a toe bonewhich is under
the corn. By doing so the toe contracture can be decreased along
with the pressure point. Surgery can be performed in an office
setting or a surgicenter, depending on the severity of the condition
and the preference of the podiatrist.
FLEXIBLE VS. RIGID HAMMERTOES
Due to new minimal invasive surgical techniques, hammertoe surgery
is a painless operation to undergo and most patients do not
require any pain medication the day following surgery. Most
patients are able to wear their own shoes 1 week after surgery
and resume work. Rigid hammertoes involve some type of bone
surgery depending on the degree of deformity. Flexible hammertoe
surgery involves a combination of tendon reconstruction and
possibly a reconstruction of the ligaments controlling the toe.
Most hammertoe surgery can be performed in an office setting.
You can contact Dr. A.J. Galluzzo in Rockford, IL
at Tel:
(815) 633-3050
or in Chicago, IL at Tel:
(312) 944-2929
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