Hammertoe is a common deformity affecting the second, third, or fourth toe, characterized by a bend at the middle joint, resembling the shape of a hammer. Initially presented as a flexible deformity, hammertoes, if left untreated, can progress to a fixed or rigid state, potentially necessitating more aggressive surgical intervention for correction.

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Symptoms

Individuals with hammertoe may develop corns or calluses on the top of the affected toe's middle joint or its tip. Pain in the toes or feet is common, alongside challenges in finding comfortable footwear. The primary complaints often revolve around discomfort caused by the middle joint rubbing against shoes or the toe's tip pressing into the ground.

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Causes

Hammertoe typically arises from ill-fitting footwear or muscle imbalances, often compounded by additional factors. Muscles operating in pairs control toe movements. Prolonged bending and confinement in one position cause muscle tightening, inhibiting stretching.

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Footwear with narrow toe boxes force toes into a flexed position, leading to friction and the formation of corns and calluses. Elevated heels exacerbate the problem by compressing toes against shoes, intensifying pressure and toe bending. Over time, toe muscles lose the ability to straighten, even in the absence of constricting footwear.

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Treatment

Conservative management commences with properly fitting shoes featuring soft, spacious toe boxes. Shoes should offer at least half an inch of space beyond the longest toe. Seek out styles with deep toe boxes or explore options for stretching existing shoes to accommodate hammertoes. Sandals may offer relief, provided they don't cause discomfort elsewhere on the foot.

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Toe exercises recommended by Dr. Kamel can strengthen and stretch toe muscles. Simple exercises like manually stretching toes or picking up objects with toes aid in muscle flexibility. Utilizing a towel underfoot to crumple with toes while seated can also be beneficial.

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Furthermore, straps, cushions, or non-medicated corn pads may alleviate symptoms. However, individuals with diabetes or circulation issues should consult a healthcare professional before attempting self-treatment.

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Surgical Intervention

When conservative measures prove ineffective, surgical correction may be warranted. Typically performed on an outpatient basis under local anesthesia, surgery aims to address the type and severity of the deformity. Post-surgery, stiffness, swelling, and redness are common, and the toe may experience slight changes in length. While walking is permitted, strenuous activities should be avoided during the healing process, with foot elevation recommended.

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Recurrence of hammertoe post-surgery is possible. Discomfort or pain in the affected toe may necessitate further surgical intervention for resolution.

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In summary, hammertoe, while initially manageable with conservative measures, may require surgical correction in advanced cases. Consulting with Dr. Kamel ensures personalized treatment plans tailored to individual needs.