The term, hammertoe
is used to describe the collective physical deformity of the second, third
and fourth toe on a person's foot when they are permanently bent at one or two of their joints, often times at their middle joints or, 'proximal interphalangeal,' joints. The condition is also
referred to as, 'contracted toes,' and earned its name for the resulting bowed appearance of the toes that made them appear similar to hammers. The distortion of the usual contour of the person's
toes is usually a result of wearing shoes that are too short or narrow and apply consistent pressure to the toes, forcing them to be pushed together and lie obliquely. The situation is particularly
true in the case of shoes that are designed to narrow towards the toe box.
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.
Symptoms may include pain in the affected toe or toes when you wear shoes, making it hard or painful to walk. A corn or callus on the top of the joint caused by rubbing against the shoe. Swelling and
redness of the skin over the joint. Trouble finding comfortable shoes.
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
The most common treatment is to wear more comfortable shoes. When choosing a shoe, make sure the toe area is high and broad and has enough room for hammer toes. If there is chronic pain, surgery may
be needed to correct a malalignment. Surgical treatments are aimed at loosening up the contracted toe joints to allow them to align properly. Other types of treatment are products designed to relieve
hammer toes, such hammertoe
as hammer toe crests and hammer toe splints. These devices will help hold down the
hammer toe and provide relief to the forefoot. Gel toe shields and gel toe caps can also be used. Gel toe shields and toe caps will help eliminate friction between the shoe and the toe, while
providing comfort and lubrication.
Your podiatrist may recommend a surgical procedure if your hammertoes are not helped by the conservative care methods listed above. Surgery for hammertoes is performed to help straighten your crooked
toe. Your surgery will be performed in your podiatrist?s office or at a hospital, depending on the severity of your hammertoe. A metal pin is sometimes used to help your affected toe maintain its
straight position during your recovery.