pathology: hammer toe

yogabook / pathologie / hammer toe

hammer toe / Digitus malleus

Definition of

Hammer toe describes an untreated progressive excessive tendency to flex in the PIP(proximal interphalangeal joint). If it can be extended passively, it is referred to as a flexible hammer toe, if the joint can no longer be extended passively, it is referred to as a rigid hammer toe. Depending on the author, a hyperextension in the DIP(distal interphalangeal joint) is also required; other authors refer to this case as mallet toe. In both cases, hammer toe leads to hyperextension in the metatarsophalangeal joint(claw toe), which is why the two usually occur together. A rare form of hammer toe is digitus superductus (crossover toe). If the hallux crosses over the second toe, it is referred to as an equestrian toe (digitus secundus superductus). An existing hallux valgus requires more flexion force due to its reduced ability to transfer force from the little toes, which can lead to contracture.

Cause

  1. Contracture or imbalance of the relevant musculature

Predisposing

– Behavior

  1. Lack of exercise, Narowuse
  2. Inadequate footwear, existing foot deformities
  3. Dancing
  4. Rolling of the foot when walking and running with flexed position of the toes

– Musculoskeletal system

  1. RA
  2. Hallux valgus
  3. Claw toe
  4. Hollow bunion (strongly concave transverse arch seen from the plantar side )
  5. Hollow foot
  6. Splayfoot

– Health factors / illnesses

  1. Compartment syndrome
  2. Poliomyelitis
  3. Overweight
  4. neuromuscular diseases (spastic paralysis, Friedreich’s ataxia)

Diagnosis

  1. Inspection
  2. Push-up test

Symptoms

  1. Initially asymptomatic, later pressure sores and discomfort occur when walking long distances or during sport, which usually disappear again at night. Over time, calluses form on the pressure points.
  2. Dorsal pressure sores, calluses and blisters, plantar calluses and corns

Complications

  1. ulcer (open area caused by friction) with a tendency to infection. Caution with diabetics!

Therapy

  1. Walking barefoot
  2. PT
  3. Training the relevant muscles
  4. Footwear with sufficient clearance
  5. Inlays
  6. only for rigid hammer toe: surgery