Hammer toe is defined as a deformity in the toe where part of the toe is permanently bent downward resembling a hammer. Two related conditions are mallet toe and claw toe which effect different toe
joints in slightly different ways. The key difference is that Hammer toes
tends to effect
the middle joint in the toe (note: not the middle toe, the middle toe joint). The disease is usually associated with the second largest toe but can effect the third or fourth toe as well. Mallet toe
effects the uppermost toe joint whereas claw toe is caused by the tow being held in a cramped ?claw-like? position.
Footwear is actually the leading cause of this hammertoe
type of toe deformity so much so that people sometimes
require hammer toe surgery to undo some of the damage. The most common problem is wearing shoes that are too short, too narrow or too tight. These shoes constricts the feet and force the toes into a
bend position. Women are more at risk especially due to high heels. Footwear isn?t the only problem, poor foot posture can lead to muscle and even bone imbalances. This asymmetry can cause excessive
strain on the toes either by forcing the toe into unnatural positions. Arthritis can also play a factor in the development of hammer toe, especially if the toe joint is stiff and incapable of a full
range of motion.
Well-developed hammertoes are distinctive due to the abnormal bent shape of the toe. However, there are many other common symptoms. Some symptoms may be present before the toe becomes overly bent or
fixed in the contracted position. Often, before the toe becomes permanently contracted, there will be pain or irritation over the top of the toe, particularly over the joint. The symptoms are
pronounced while wearing shoes due to the top of the toe rubbing against the upper portion of the shoe. Often, there is a significant amount of friction between the toe and the shoe or between the
toe and the toes on either side of it. The corns may be soft or hard, depending on their location and age. The affected toe may also appear red with irritated skin. In more severe cases, blisters or
open sores may form. Those with diabetes should take extra care if they develop any of these symptoms, as they could lead to further complications.
First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a
metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in
the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.
Non Surgical Treatment
Conservative treatment is limited to accommodation, not correction, of the deformity, though some patients find the relief they can get from these options to be more than enough to put off or even
avoid surgery. These include better Footwear. Shoe gear with a wider toe box and higher volume causes less friction to the toes. Toe Braces and Strapping. Some toe braces and strapping techniques
take some pressure off the toes during gait. Custom molded orthotics can redistribute the forces through the tendons that control the toe, lessening the pain and extent of the deformity.The calluses
on the toe and the ball of the foot can be shaved occasionally to reduce some pain and pressure, although they will return due to the constant deformity.
If conservative measures fail to provide relief, or if your hammertoe is in advanced stages with rigidity and a significant amount of pain, surgery may be required. Some patients also require surgery
if they have open sores or wounds related to their hammertoe. For patients who also suffer from bunions, a combined procedure may be appropriate, addressing both conditions within the same surgery.
Recovery time will vary from patient to patient, depending on the extent of the surgical repair and other conditions that may also be present.