Treatment Specialties

Disorders

Hammertoes

A hammertoe is a term used to describe a crooked, deviated, or contracted toe. Although the condition usually stems from muscle imbalance, it is often aggravated by poor-fitting shoes or socks that cramp the toes. Over a period of years, the tendons that move the toe up and down begin to pull the toe with unequal tension, and the toe then begins to buckle or become contracted, causing an abnormal "v"-shaped bending of the little toes.

Causes
While most cases of hammertoes are caused by an underlying muscle imbalance, it may develop as a result of several different causes, including arthritis, a hereditary condition, an injury, or ill-fitting shoes. In some cases, patients develop hammertoes after wearing shoes or stockings that are too tight for long periods of time. These patients usually develop hammertoes in both feet.

Symptoms
Patients with hammertoes often experience pain or irritation in the affected toes, especially when wearing shoes. Many patients develop corns and calluses on or in between the toes as a result of the constant friction between the toe and a shoe. Hammertoes often start out causing only mild pain and remain flexible. If left untreated, this condition will worsen over time, becoming more rigid and increasingly non-responsive to conservative treatment methods.

Treatment
Treatment for hammertoes depends on the severity of the condition, but may include several home remedies such as wearing different shoes and protecting corns and calluses with over-the-counter pads. Anti-inflammatory medication, such as ibuprofen, may also be effective in relieving pain and inflammation caused by this condition. More severe cases of hammertoes may require custom-made orthotic devices to relieve the underlying muscle imbalance in the feet and reduce the symptoms that it causes.

Surgery may be required when toes become extremely rigid, and involves removing a small section of bone from the affected joint through a procedure called arthroplasty. Arthrodesis may also be performed to treat hammertoes, which involves fusing together one of the joints in the toe in order to keep it straight. This procedure requires the use of a metal pin to hold the toe in position while it heals. Dr. Axt will decide which treatment is best for you after a thorough evaluation of your condition.

Bunions

A bunion is a common condition that involves an abnormal, bony bump at the base of the big toes, causing the joint to swell outward and become painful. The deformity arises when a progressive dislocation of the joint causes the big toe to drift toward the second toe. Simultaneously, the first metatarsal bone separates or spreads in the opposite direction, causing the bony enlargement on the inside of the foot and pain to develop as a result.

Causes
Bunions can form when there is an improper balance of forces exerted on the joints of the foot, causing instability in the joint of the big toe. This often occurs as a result of shoes that do not fit properly, abnormal walking habits or an inherited foot type. Bunions can also be caused by injury, birth defects, arthritis, or certain neuromuscular disorders.

Symptoms
Patients with a bunion experience pain as a shoe applies pressure against the bony prominence. This condition may also cause difficulty walking, ingrown toenails, and corns and calluses. While bunions are usually not a serious condition, many patients are embarrassed by their appearance and seek treatment for cosmetic purposes. If left untreated, bunions tend to grow larger and become more painful over time. It is important for patients to seek proper medical attention for a bunion.

Treatment
Bunion treatment depends on the severity of the condition, although early treatment is considered most effective. Mild bunions can often be relieved of pain simply by changing shoes, applying ice or taping your foot into a normal position. Medications, orthotics and physical therapy may also be recommended by Dr. Axt.

Surgery to treat bunions is often reserved for more severe cases, or after conservative treatment has failed. There are several different surgical options available, depending on the cause and symptoms of the bunion. The most common surgical procedure for bunions is a bunionectomy, which involves removing the swollen tissue from the joint, as well as part of the bone, in order to straighten the big toe. This procedure may be performed alone or in conjunction with others in order to relieve symptoms and restore function to the toe.

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