Hammer toes can result in pain and difficulty in moving the toe. Corns, calluses and blisters can occur from the rubbing of the contracted toe against the inside of the footwear. Both hammertoes
and mallet toe can cause pain during walking, running and other activities. If left untreated, the tendons of the toe may contract
and tighten, causing the toe to become permanently stiff and contracted. A podiatric physician or surgeon may have to cut or realign tendons and/or remove pieces of bone to straighten the toe. This
may require that the bones be fixed temporarily with pins while the toe heals.
Risk factors for hammertoe include heredity, a second toe that is longer than the first (Morton foot), high arches or flat feet, injury in which the toe was jammed, rheumatoid arthritis, and, in
diabetics, abnormal foot mechanics resulting from muscle and nerve damage. Hammertoe may be precipitated by advancing age, weakness of small muscles in the foot (foot intrinsic muscles), and the
wearing of shoes that crowd the toes (too tight, too short, or with heels that are too high). The condition is more common in females than in males.
Common reasons patients seek treatment for toe problems are toe pain on the knuckle. Thick toe calluses. Interference with walking/activities. Difficulty fitting shoes. Worsening toe deformity. Pain
at the ball of the foot. Unsightly appearance. Toe deformities (contractures) come in varying degrees of severity, from slight to severe. The can be present in conjunction with a bunion, and develop
onto a severe disfiguring foot deformity. Advanced cases, the toe can dislocate on top of the foot. Depending on your overall health, symptoms and severity of the hammer toe, the condition may be
treated conservatively and/or with surgery.
Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your
foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
Pad it. Mild cases of hammertoe can be treated with corn pads or felt pads available in the pharmacy. Toe caps, the small, padded sleeves that fit around the tip of the toe, may relieve hammer toe
pain. Change your shoes. Wear wide shoes with resilient soles. Avoid shoes with pointed toes. Exercise. Certain exercises such as moving and stretching your toe gently with your hands and picking
small or soft objects such as marbles or towels can keep your toe joints flexible. Also, while you are watching television or reading, you can also put a towel flat under your feet and use your toes
to crumple it. This simple exercise can stretch and strengthen your muscles. Use ice. If your hammer toe becomes painful, applying an ice pack several times a day can help relieve the soreness and
Take medications. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen or naproxen may be helpful in minimizing pain and inflammation. Use orthotic devices. Place a custom
orthotic device in your shoe. This will help control the muscle/tendon imbalance.
The deformity is corrected in a variety of ways. There are actually a large number of procedures. The simplest procedure would involve a Tenotomy, the cutting of the tendon causing the deformity or a
Tendon Lengthening Hammer toes
procedure. These procedures are
infrequently done, though, as the structural deformity (the arthritis and joint adaptation) is not addressed with these surgeries. Other soft-tissue procedures involve rebalancing the tendons around
the joint. There are several techniques to do this, but the most common is probably the Girdlestone-Taylor procedure, which involves rerouting the tendons on the bottom of the toe up and over the toe
where it sticks up, so that the tendon helps pull the toe downwards into proper alignment.