The term hammertoe
describes three unique contracture deformities of the toes. The deformities
differ by the location of contracture in each joint of the toe. The three deformities include hammer toe, claw toe and mallet toe. Hammer toes may be flexible or rigid. Hammer toes are most common on
the lesser toes (2-5) and may affect one or more toes simultaneously. Hallux malleus is the term used to described a hammer toe of the great toe. Hallux malleus is often found as an isolated foot
problem. Hammer toes are found equally in men and women. The onset of hammer toes is between the ages of 30 and 80 years of age.
The muscles of each toe work in pairs. When the toe muscles get out of balance, a hammertoe can form. Muscle imbalance puts a lot of pressure on the toe's tendons and joints. This pressure forces the
toe into a hammerhead shape. How do the toe muscles get out of balance? There are three main reasons. Genes. you may have inherited a tendency to develop hammertoes because your feet are somewhat
unstable, they may be flat or have a high arch. Arthritis. Injury to the toe, ill-fitting shoes are the main culprits. If shoes are too tight, too short, or too pointy, they push the toes out of
balance. Pointy, high-heeled shoes put particularly severe pressure on the toes.
The symptoms of hammertoe include a curling toe, pain or discomfort in the toes and ball of the foot or the front of the leg, especially when toes are stretched downward. Thickening of the skin above
or below the affected toe with the formation of corns or calluses. Difficulty finding shoes that fit well. In its early stages, hammertoe is not obvious. Frequently, hammertoe does not cause any
symptoms except for the claw-like toe shape.
The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear
crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at
the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still
flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the
involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.
Non Surgical Treatment
Podiatric Care may include using anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce this swelling. When you go to your doctor, x-rays are usually required
to evaluate the structure of your foot, check for fractures and determine the cause. The podiatrist may see you to take care of any corns that develop due to the bone deformities. They may advise you
on different shoewear or prescribe a custom made orthotic to try and control the foot structure. Padding techniques may be used to straighten the toe if the deformity is flexible, or pads may be used
to lessen the pressure on the area of the corn or ulcer. Your podiatric physician may also recommend a surgical procedure to actually fix the structural problem of your foot.
In advanced cases in which the toe has become stiff and permanently bent, the toe can be straightened with surgery. One type of surgery involves removing a small section of the toe bone to allow the
toe to lie flat. Surgery for hammertoe usually is classified as a cosmetic procedure. Cosmetic foot surgeries sometimes result in complications such as pain or numbness, so it's better to treat the
problem with a shoe that fits properly.
The best ways to prevent a hammertoe are. Wear shoes that fit well. Shoes should be one-half inch longer than your longest toe. Shoes should be wide enough and the toe box should be high enough to
give the foot room to move. Don?t wear shoes with heels over 2 inches high. If a toe starts to look like a hammertoe, buy shoes that have an extra high toe box. Wear corn pad removers or cushion pads
on top of the affected toe. See your healthcare provider any time you have foot pain that does not hammertoes
go away quickly or is more than mild pain. Foot pain is not normal.