2015/06/27 (Sat) 06:33
Hammer Toe Repair Pinning

HammertoeOverview


Essentially, there's one consistent type of hammertoe, the condition in which your toes are contracted into a hammer or upside-down "V" shape. However, depending on its severity, hammertoe is characterized into two forms. Flexible hammertoe is hammertoe in which the joints of the toes are still moveable or flexible and can be treated with nonsurgical therapies. Rigid hammertoe is the more serious condition in which the joints' muscles and tendons have lost any flexibility and the contraction cannot be corrected by nonsurgical means. As a result, surgery is generally required to deal with the problem. This is why it's important to consult a physician as soon as the problem is recognized Hammer toe for the possibility of successful nonsurgical treatment.


Causes


Some causes of hammertoe are shoes that are too tight or short, shoes with high heels, injury, Diseases that affect the nerves and muscles, such as arthritis and diabetes. When shoes do not fit well, over time the pressure of the shoes pushes the toes into a bent position. After a while, the muscles become unable to straighten the toe, even when you are not wearing shoes. Similarly, when there is damage or disease of the nerves or muscles in the toes, the toe may rest in the bent position until the tendons become permanently shortened and the toe becomes a rigid hammertoe. The risk of developing a hammertoe increases with age. Women are much more likely to develop a hammertoe than men.


HammertoeSymptoms


At first, a hammertoe or mallet toe may maintain its flexibility and lie flat when you're not wearing crowded footwear. But eventually, the tendons of the toe may contract and tighten, causing your toe to become permanently stiff. Your shoes can rub against the raised portion of the toe or toes, causing painful corns or calluses.


Diagnosis


First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.


Non Surgical Treatment


Wearing proper footwear may ease your foot pain. Low-heeled shoes with a deep toe box and flexible material covering the toes may help. Make sure there's a half-inch of space between your longest toe and the inside tip of your shoe. Allowing adequate space for your toes will help relieve pressure and pain. Avoid over-the-counter corn-removal products, many of which contain acid that can cause severe skin irritation. It's also risky to try shaving or cutting an unsightly corn off your toe. Foot wounds can easily get infected, and foot infections are often difficult to treat, especially if you have diabetes or poor circulation.


Surgical Treatment


Sometimes, if the deformity is severe enough or surgical modification is needed, the toe bones may be fused so that the toe does not bend. Buried wires are used to allow for the fusion to heal, and they remain in place after healing. Your skin is closed with fine sutures, which are typically removed seven to ten days after surgery. A dressing is used to help keep your toes in their new position. Dressings should not get wet or be removed. After surgery, your doctor may prescribe pain relievers, typically for the initial four to seven days. Most people heal completely within one month of surgery, with few complications, if any. Crutches or a cane may be needed to help you keep weight off your affected foot, depending on the procedure. Occasionally, patients receive a special post-op shoe or a walking boot that is to be worn during the healing process. Most people are able to shower normally after surgery, but must protect the dressing from getting wet. Many patients are allowed to resume driving within one week after the procedure, but care needs to be taken.


HammertoePrevention


The key to prevention is to wear shoes that fit you properly and provide plenty of room for your toes. Here?s how to get the right fit. Have your feet properly measured. The best way to do this is to get someone to draw the outline of your foot while you stand barefoot with your full weight on it, then measure the outline at the widest point. Measure the soles of your shoes. Ideally, they should be as wide as your feet, but certainly no more than half an inch narrower. Length matters, too, of course: your shoes should be half an inch longer than your longest toe.

tag : Hammer Toes

2015/06/26 (Fri) 19:50
Hammertoe Correction Without Surgery

HammertoeOverview


If the joint on one of your toes, usually the toe next to the big toe or the smallest toe, points upward rather than lying flat, you might have a Hammer toe. The condition is actually a deformity that happens when one of the toe muscles becomes weak and puts pressure on the toe?s tendons and joints. This pressure forces the toe to become misshapen and stick up at the joint. Also, there?s frequently a corn or callus on top of the deformed toe. This outgrowth can cause pain when it rubs against the shoe.


Causes


Certain risk factors increase your likelihood of developing a hammertoe. These include a family history of hammertoes, wearing tight or pointy-toed shoes, wearing shoes that are too small, having calluses, bunions, or corns (thickened layers of skin caused by prolonged/repeated friction) Wearing shoes that are too small can force the joint of your toes into a dislocated position. This makes it impossible for your muscles to stretch out. Over time, the practice of wearing improperly fitting shoes increases your risk of developing hammertoes, blisters, bunions, and corns.


Hammer ToeSymptoms


The middle joint of the toe is bent. The end part of the toe bends down into a claw-like deformity. At first, you may be able to move and straighten the toe. Over time, you will no longer be able to move the toe. It will be painful. A corn often forms on the top of the toe. A callus is found on the sole of the foot. Walking or wearing shoes can be painful.


Diagnosis


First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates Hammer toes that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.


Non Surgical Treatment


Prescription strength medicines to decrease pain and inflammation. Physical Therapy. To strengthen poorly functioning muscles and stretch tight muscles that may be exacerbating the toes. Special ultrasound techniques may reduce inflammation. Custom Foot Orthotics. An orthotic with an exact mold of your foot to better align and support the foot to ease current discomfort and prevent future progression. Toe Splints or Pads. Specific pads may prevent pressure and physical irritation in shoes. Toe splints and toe spacers physically realign the toes and can lessen pain and halt or stall hammer toe progression. Cortisone injections are strong anti-inflammatory agents to decrease pain, and swelling directly at the toe region. Injections only treat the symptoms, and in some cases used in caution (and sparingly) they can weaken supporting ligaments of the toe(s).


Surgical Treatment


Surgery may not help how your foot looks. And your toe problems may also come back after surgery. This is more likely if you keep wearing the kinds of shoes that cause toe problems. Your expectations will play a large role in how you feel about the results of surgery. If you are only having surgery to improve the way your foot looks, you may not be happy with how it turns out.

tag : Hammertoe

2015/06/07 (Sun) 01:49
What Exactly Are Hallux Valgus?


Overview
Bunion Pain
A bunion is a combination of an enlargement of the joint at the base and side of the big toe as well as the big toe being angled towards the rest of the toes (this angulation is known as Hallux Valgus). A bunion can lead to other foot deformities and problems such as a hammer toe of the second toe, corns and calluses as well as ingrown toenails. So if the pain isn't enough of a driving factor, the chance of developing these further complications should outline the importance and urgency of seeking treatment with a podiatrist.

Causes
Bunions are a common problem that can cause foot pain and difficulty wearing shoes. Bunions occur in about 30% of the population of most Western countries. They are seen most commonly in women and become more common as people get older. Patients with bunions generally have one of two problems that can cause pain. As the big toe becomes more and more angled (pointing toward the other toes), the base of the toe becomes more and more prominent, forming the bunion. The bunion forms in part because of the new angle of the toe, and in part due to inflammation over the bunion surface. As the inflammation worsens, people can experience pain with shoe wear and walking. The big toe may eventually come to lie over, or more commonly under, the second toe. This may cause further irritation while wearing shoes and more pain. The second toe of patients who have bunions commonly forms a hammer toe.
SymptomsSymptoms of a bunion include irritated skin, sensitivity to touch, and pain when walking or running. Since the bunion may grow so prominent as to affect the shape of the foot, shoes may no longer fit properly, and blisters may form at the site of friction and pressure. Bunions may grow so large that an individual must wear shoes that are a larger size than they would otherwise wear. If the bunion becomes a severe case, walking may become difficult.

Diagnosis
Looking at the problem area on the foot is the best way to discover a bunion. If it has the shape characteristic of a bunion, this is the first hint of a problem. The doctor may also look at the shape of your leg, ankle, and foot while you are standing, and check the range of motion of your toe and joints by asking you to move your toes in different directions A closer examination with weight-bearing X-rays helps your doctor examine the actual bone structure at the joint and see how severe the problem is. A doctor may ask about the types of shoes you wear, sports or activities (e.g., ballet) you participate in, and whether or not you have had a recent injury. This information will help determine your treatment.

Non Surgical Treatment
A bunion treatment must address the underlying cause of the deformity, not just the bump (bunion) itself but also the functions of the foot. The up and down motion of the longitudinal arches in the foot. The sideways motion of the transverse arch. Bunion aids effectively treat this underlying foot function while straightening the big toe because the mid-foot strap stabilizes the longitudinal arches and transverse arch. The toe strap gradually and gently pulls the big toe away from the second toe. The metatarsal pad helps align the transverse arch. The hinged splint enables the big toe to flex while walking and adapts to the contour of the foot, especially around the inflamed area of the joint.
Bunions

Surgical Treatment
If these methods fail, then surgery may be suggested. Basically, bunion surgery is performed to improve function or to prevent pain from occurring. When surgery is delayed in a symptomatic foot, greater amounts of arthritis can develop and the more complicated surgery can become. Surgery is performed to improve alignment and function to the big toe joint. The large bump is removed and, sometimes, a cut is made into the bone, to move it to a more normal position. Screws, pins and wires can be used beneath the skin, to improve healing and results. Healing can range from 3-12 weeks, depending on the procedure.

Prevention
Bunions often become painful if they are allowed to progress. But not all bunions progress. Many bunion problems can be managed without surgery. In general, bunions that are not painful do not need surgical correction. For this reason, orthopaedic surgeons do not recommend "preventive" surgery for bunions that do not hurt; with proper preventive care, they may never become a problem.

tag : Bunions

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