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New treatment for painful hammertoe condition

January 17, 2011 12:00:00 AM PST
Thirty minutes of daily exercise is key to keeping fit. If you're walking, that could add up to 10,000 steps every day. But millions of Americans have a foot problem that makes every step painful. Now there's a new treatment that's helping sufferers get back on their feet.Ill-fitting shoes are the number-one cause of a hammertoe.

"Tape a rock, a pebble under your toe and try walking around barefoot," said Mary Lou Barlow.

For years, every step Barlow took hurt.

"I couldn't walk on it because if I did I had to wear something cushioned; I couldn't go barefoot," said Barlow.

Barlow suffered with hammertoes -- toes bent painfully out of their normal position. The traditional treatment is a long pin sticking out the front of the toe that stays in for weeks to straighten it.

"It was just too traumatic, I just didn't want to do it," said Barlow.

Duke University orthopedic surgeon Dr. Selene Parekh told Barlow she was a good candidate for a new "smart toe" implant.

"We'll cut a little bit of the bone out and we'll drop the implant into the bone, into the two bones that surround the joint. That will then hold the toe straight," said Parekh,

Kept on ice before surgery, the implant expands with the heat of the body, holding the bone in place while it heals.

"This has been a revolutionary change for hammertoe surgery," said Parekh.

Just five weeks after getting the implant, Barlow is back on her feet, even going barefoot without pain.

"I am going to be running around the house without shoes on from now on," said Barlow, a busy woman happy to be back in step with her active lifestyle.

The hammertoe implant is performed as a same-day outpatient procedure. Patients wear a special therapeutic shoe for the first few weeks after surgery. Once the implant is in the joint, the patient is not able to bend the affected toe, but several weeks after surgery they can wear almost any kind of shoes, even high heels, or go barefoot without the discomfort they used to have.


BACKGROUND: Hammertoe is a condition where the smaller toes of the foot become bent like a claw and can leave permanent damage. There are three main causes of hammertoe. The deformity can be inherited, a result of arthritis or develop because of ill-fitting shoes. Ill-fitting shoes are the culprit of this deformity. Studies show that women are more likely than men to develop hammertoe because of shoe style. (SOURCE: www.mamashealth.com)

TYPES OF HAMMERTOE: There are two types of hammertoe. Flexible hammertoe is the less severe type with the toe still able to move at the joint. If hammertoe is diagnosed at this stage, more treatment options are available. With rigid hammertoe the joint is completely out of alignment and can't be move. This condition could make walking painful and at this stage, surgery may be suggested. (SOURCE: www.webmd.com)

TREATMENT: Products like hammertoe crests and hammertoe splints are foot devices that provide comfort for mild cases of hammertoe. These products position the foot in a certain way that helps prevent the hammertoe from becoming aggravated. In addition, wearing corrective footwear can protect the protruding joint. If chronic pain develops, physicians may suggest operations to surgically straighten the joint. Treatment options include removing a portion of the joint to straighten it, fusing two toe bones together or removing a portion of the bone and replacing it with an implant. (SOURCE: www.yourfoothealth.com)

WHAT TO EXPECT: Hammertoe surgery is one of the most successful procedures with over 300,000 surgeries performed each year. General complications include swelling, stiffness and limited mobility anywhere from eight to twelve weeks. Swelling can be reduced after surgery by keeping the foot elevated and applying ice. Most physicians recommend wearing a splint or surgical shoe to protect the foot and help balance the body weight. Resuming normal activity is possible without significant disruption. (SOURCE: www.podiatrytoday.com)

Tiandra Grey
Duke University Health System
(919) 403-5180

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