A Hammer toes
is a deformity of the middle joint of a toe, producing a clenched, clawlike
appearance in the affected digit. The tendons in the toe become abnormally contracted, causing the toe to bend downward, which, in turn, forces the joint to protrude upward. A mallet toe is a
deformity in which the end joint of a toe becomes bent downward, so that the toe curls underneath itself. In either case the affected joints are stiff, and often the toe cannot be straightened out.
Constant rubbing against shoes may furthermore cause a painful corn (a round patch of rough, thickened, calloused skin) to develop over the joint or at the tip of the affected toe. Hammer and mallet
toes may occur in any toe, although the second toe is the most common site. These deformities are often painful and limit the toe?s range of motion-sometimes requiring surgery.
Hammertoe has three main culprits: tight shoes, trauma, and nerve injuries or disorders. When toes are crowded in shoes that are too tight and narrow, they are unable to rest flat, and this curled
toe position may become permanent even when you aren't wearing shoes due to the tendons of the toe permanently tightening. When the tendons are held in one position for too long, the muscles tighten
and eventually become unable to stretch back out. A similar situation may result when tendons are injured due to trauma, such as a stubbed, jammed, or broken toe.
People who have painful hammertoes visit their podiatrist because their affected toe is either rubbing on the end their shoe (signaling a contracted flexor tendon), rubbing on the top Hammer toe
of their shoe (signaling a contracted extensor tendon), or rubbing on another toe and causing a painful buildup of thick skin,
known as a corn.
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination,
the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the
degree of the deformities and assess any changes that may have occurred.
Non Surgical Treatment
Your doctor will decide what type of hammertoe you have and rule out other medical conditions. Treatment may range from more appropriate footgear to periodic trimming and padding of the corn.
Cortisone injections may be indicated if a bursitis is present. Antibiotics may be utilized in the presence of infection. Removable accommodative pads may be made for you.
Surgery is used when other types of treatment fail to relieve symptoms or for advanced cases of hammertoe. There are several types of surgeries to treat hammertoe. A small piece of bone may be
removed from the joint (arthroplasty). The toe joint may be fused to straighten it (arthrodesis). Surgical hardware, such as a pin, may be used to hold the bones in place while they heal. Other types
of surgery involve removing skin (wedging) or correcting muscles and tendons to balance the joint.
Plainly put, most toe deformities are caused by footwear. If you wish to avoid bunions or hammertoes, or works towards reversing them, please choose your footwear that has a low heel, and is wide
enough in the toebox to spread you toes. Your podiatrist or therapist can help with the manipulation exercises. Bunion splints are available.