Summary:

锤状趾是脚趾在狭小的环境中被挤压形成弯曲畸形的一种病理表现。锤状趾是可以进行弯曲活动的，但是一些因素易致其所属的关节发生僵直。

Hammering toe is a pathological expression of the toe forming in a narrow environment. Hammering toes can bend, but some factors can cause stiff joints.

病因：

Pathogeny:

某些特殊的足部病变，如扁平足或足部拇囊炎可引起拇趾处的肌肉和肌腱张力增加及有效长度缩短，形成锤状趾。锤状趾的形成也可因穿着内部空间狭小的鞋、迈步时鞋后跟无法被脚后跟一起提起而需要脚趾弯曲用力来固定的凉鞋或T 字鞋（人字拖）以及足趾局部损伤和关节炎等。

Certain special foot lesions, such as flat feet or thumb bursitis, can cause increased muscle and tendon tension and shortened effective length at the thumb, forming a mallet toe. Hammer toes can also be formed by wearing shoes with a narrow internal space, walking shoes with heels can not be lifted together and need to bend toes to fix sandals or T-shaped shoes (flip-flops) and toe injury and arthritis.

症状：

Symptom:

形成锤状趾后关节活动度可能会受到影响，且可能会有疼痛感，关节处也很有可能发生红肿等病理表现。跖骨受力部有时会形成溃疡，锤状趾顶部也极有可能形成鸡眼，最终引起步态的改变。对于糖尿病足人群，锤状趾上形成的溃疡和水泡是引发足部感染的高危因素，一旦感染发生，极有可能导致不同程度的截肢。

Posterior mallet toe joint motion may be affected, and there may be pain, joints are also likely to occur swelling and other pathological manifestations. Sometimes ulcers form in the stress part of the metatarsal bones, and there is a good chance that the mallet toe top will form the chicken's eye, which will eventually lead to gait changes. For people with diabetic foot, ulcers and blisters on the hammertoe are high-risk factors for foot infections. Once the infection occurs, it is likely to lead to varying degrees of amputation.

治疗：

Treatment:

病理情况不同，其治疗措施往往也不同。

Pathological conditions are different, and their treatment measures are often different.

非手术治疗主要包括以下几点：

Non operative treatment mainly includes the following points:

1.穿合适的鞋，足趾在鞋内能够正常的伸缩，且鞋面前端要有弹性。同时鞋前掌处要有足够的深度以满足足趾的高度，避免发生局部摩擦。

1., wear appropriate shoes, toes in the shoes can be normal expansion, and the front end of the shoe should be elastic. At the same time, the front of the shoe should have enough depth to meet the height of the toes and avoid local friction.

2.利用足部矫形器，将前掌的受力转移到中/后足。对于形成关节僵硬的锤状趾，足跖趾近段给予一定的保护性跖骨条/垫支撑。

2. use the foot orthosis to transfer the force of the front palm to the middle / hind foot. For the hammer shaped toe forming joint stiffness, a protective metatarsal strip / pad support is provided at the proximal part of the metatarsophalangeal.

3.使用椭圆形的鸡眼或老茧垫缓解患部的压力。

3. use elliptical corns or callus pad to relieve pressure on the affected part.

4.通过对鞋底进行前掌拱形底改造，使得向前迈步更加轻松。减少前掌迈步时的停留时间。外科手术治疗包括通过切除部分肌腱来重新调整足趾对线定位和进行关节成形术.

4. by transforming the sole of the sole into the arched bottom, the step forward is easier. Reduce the residence time when your front legs move. Surgical treatment includes resection of part of the tendon to readjust the alignment of the toe and arthroplasty.

矫形方案：

Orthopaedic scheme:

1.穿前掌内高大于锤/爪状趾高度的加深鞋/靴；

1. deep Shoes / boots with a height higher than the hammer / claw toe in the front palm.

2.如果爪状趾的活动度良好，可使用足趾夹板(见背页),如分趾器进行局部矫正固定；

2. If the claw toe is in good motion, toe splint (see back page) can be used, such as toe splitter for local correction and fixation;

3.使用有跖骨垫的足部矫形器，通过支撑跖骨后段底部，减轻足趾受压，缓解锤/爪状趾相应症状；

3. Using a foot orthosis with a metatarsal pad to support the bottom of the posterior segment of the metatarsal bone can relieve the compression of the toe and relieve the symptoms of the hammer/claw toe.

4.通过对鞋底进行拱形底改造，减短迈步前行过程中足趾的受力时间。

4. by changing the sole of the sole, the force time of the toe is shortened.