Foot Care For You"Foot Surgery is a last resort, not first aid."- Dr. Burton Schuler
1976

Dr. Burton Schuler
Podiatrist - Foot Specialist - Foot Doctor
2401 W. 15th Street
Panama City, FL 32401

Hours: Mon-Thur 8:30 - 4 | Friday 8:30 - Noon
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"Common Foot Ailments"

Hammer Toes

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Can Hammertoe Surgery be Avoided asks Panama City Podiatrist

This article was publishes this year around the country

Hammertoes occur when toe tendons have tightened on the top, causing them to appear angular and disfigured.  Mayo Clinic describes a hammertoe as a toe that is curled due to a bend in the middle joint.  On the Mayo Clinic website, the cause of hammertoe is attributed to poorly fitting shoes–such as ones that are tight in the toe box or high heels. When your toe is forced to the front of your shoe, the result is an unnatural bending of your toe and a hammer-like or claw-like appearance (http://www.mayoclinic.com/health/hammertoe-and-mallet-toe/DS00480).

But are properly fitting, comfortable shoes surefire prevention against hammertoes?  Not necessarily.  While the Mayo Clinic lists bad shoe wear as a cause of hammer toes, other sources suggest that it can be caused by a longer second toe (also known as Morton’s Toe).

In Why You Really Hurt: It All Starts in the Foot, Dr. Burton S. Schuler, who graduated from the New York College of Podiatric Medicine in 1975 at the age of 24, and has seen his fair share of Morton’s Toes (http://whyyoureallyhurt.com/mortons-toe/hammer/.)  Schuler advances the idea that Morton’s Toe can be the cause of hammertoes (and corns, which are due to the rubbing of the top of the toes on the shoes). Hammertoes are related to Morton’s Toe since the foot undergoes abnormal pronation and pressure becomes unevenly distributed throughout the toes and foot when the second toe is longer.

If you have Morton’s Toe, one way to avoid developing hammer toes is if you place a toe pad under your first toe.  If the hammertoe is too advanced, surgery may be necessary.  According to Schuler, surgery chosen is decided by whether we are dealing with a flexible or rigid hammer toes. If the surgery is on a flexible hammer toe, it is performed on soft tissue structures like the tendon and or capsule of the flexor hammer toe. Rigid hammer toes need bone surgeries into the joint of the toe to repair it. This bone surgery is called an arthroplasty.  (http://www.footcare4u.com/category/hammer-toes/).

2003 data from the Centers for Medicare and Medicaid Services states that out of 300,000 hammertoe surgeries performed annually–over 50,000 patients are unsatisfied with the results (http://www.podiatrytoday.com/minimizing-risk-failed-hammertoe-surgery).  Thus, early diagnosis of Morton’s Toe can help prevent a later surgery that has a high chance of being unsatisfactory anyway.

Hammer Toes

Hammer toes is when the joint of the toes curl down. The reason they curl abnormally is due to a muscle imbalance which results in the tendons becoming unnaturally tight. They are due to Heredity, improper shoes, and Arthritis

There are two types of hammer toes:

1. flexible

or

2. rigid.

These classification are based on the mobility of the toe joints. A flexible hammer toe is one with a flexible toe joint that allows it to be straightend with your finger. In time a flexible joint may turn into a rigid hammer toe. Normally flexible hammer toes are much less painful than rigid hammer toes. A rigid hammer toe is one with a rigid toe joint, one that is not moveable with your finger. These rigid toe joints can be very painful and limit the ability to move. As I write about in my book Why You Really Hurt: It All Starts In The Foot, hammer toes are caused by a problem known as Morton’s Toe to move. Corns that appear on the toes especially the 5th and 2nd toes are a direct result of hammer toes, due to the rubbing of the top of the toes on the shoes. Treating the Morton’s Toe can help this problem. Also a shoe with what is known as a “high toe box” can help. Avoid using the over the counter “corn medications” espically if you are a diabetic. They do nothing but burn the skin off of your toes.

Sometimes surgery can not be avoided. If needed, the surgery chosen is decided by whether we are dealing with a flexible or rigid hammer toe. If the surgery is on a flexible hammer toe, it is performed on soft tissue structures like the tendon and or capsule of the flexor hammer toe. I describe this surgery in the section under Calluses

Rigid hammer toes need bone surgeries into the joint of the toe to repair it. This bone surgery is called an arthroplasty. As I wrote in my book The Agony Of De-Feet, all hammer toe surgeries should be done out of the hospital in the doctor’s office or surgical center.

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