骨科小病不求医007：锤状趾（HAMMER TOE）

      锤状趾指的是2、3、4、5趾一个或两个关节弯曲，第2趾最常见。这种不正常弯曲能使趾头在鞋内的压力增加，引起溃疡。早期轻度畸形，后进行性加重，趾头越来越弯曲而僵硬，直至对非手术治疗无反应。常发生在穿高跟鞋或窄头鞋的妇女。

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Overview（概述）

This condition is a deformity in which a toe bends downward at the middle joint. The second toe is the one most likely to be affected, but this deformity can occur in other toes as well. Sometimes, more than one toe is affected.

      锤状趾是脚趾的中间关节向下弯曲的一种畸形。常累及第二脚趾，畸形也可发生于其它脚趾。有时，可有多个脚趾发生畸形。

Causes（原因）

Hammer toe can be caused by certain types of footwear - especially women's shoes - that put pressure on the toes and don't provide proper space for them. High-heeled shoes and shoes with narrow toe boxes are common culprits. These can force the toes to bend into an abnormal position. Hammer toe can also develop as a result of injury, nerve damage, a muscle imbalance in the toes, or a bunion that pushes the big toe out of alignment.

      锤状趾可因穿某些种类的鞋子引起，特别是那些对足趾造成压迫，不能为足趾提供足够空间的女鞋。高跟鞋和前端容纳足趾处狭窄的鞋子是常见的致病原因。这些鞋子迫使足趾弯曲在异常的位置。锤状趾也可继发于外伤、神经损伤、足趾肌肉不平衡或把足趾挤出正常序列的拇趾外翻畸形。

Symptoms（症状）

The most obvious symptom of hammer toe is a downward, claw-like bend in the toe at the middle joint. The toe will be flexible at first, but without treatment it can become rigid. A hammer toe may be painful, and movement can be difficult. Corns and calluses may form as the toe rubs against the shoe.

      锤状趾显而易见的症状是足趾中间关节爪状向下弯曲。起初，足趾还能灵活屈伸，如果不治疗，将会变得僵硬。锤状趾会引起疼痛，可能行走困难。因足趾与鞋子反复摩擦，会出现鸡眼和老茧。

Treatment（治疗）

Treatment will vary depending upon the stage of the condition. Conservative treatment options include flat shoes with roomy toe boxes, and the use of inserts, pads or cushions. Toe exercises may help stretch and strengthen the toe muscles. If these options are not successful, surgery may be needed to straighten the toe.

      根据病程的不同阶段，有不同的治疗方法。保守治疗方法包括穿足趾部位宽松的平底鞋，使用插块、护具或软垫。足趾操有助于伸展和加强足趾的肌肉力量。如果这些方法无效，可能需要手术将足趾做直。

（胡佰文    译）