is a painful deformity wherein a toe bends unnaturally and becomes clawlike. This
happens because the tendons of the Hammer toe
toe contract abnormally, forcing the toe to bend
downward and the middle joint of the toe to protrude upward. Although any toe may be affected, hammertoe usually affects the second toe. The toe assumes a clawlike position and cannot be straightened
out. When someone with hammertoe wears shoes, the toe is constantly rubbed, so walking may become especially painful if a callus on the sole of the foot or a corn on the top of a toe develops.
Shoes that narrow toward the toe may make your forefoot look smaller. But they also push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of
corns and calluses, which further aggravate the condition. A higher heel forces the foot down and squishes the toes against the shoe, increasing the pressure and the bend in the toe. Eventually, the
toe muscles become unable to straighten the toe, even when there is no confining shoe.
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.
A hammertoe is usually diagnosed with a physical inspection of your toe. Imaging tests, such as X-rays, may be ordered if you have had a bone, muscle, or ligament injury in your toe.
Non Surgical Treatment
Many people start by treating the problem themselves when they have a painful corn or callus. They try to remove the corn by cutting it off or by applying strong acids, and they try to cushion the
toe by applying cushioned pads. Because these treatments can be difficult to perform by oneself (and should never be done by oneself when the patient is diabetic or circulation is poor), and because
these treatments only treat the symptom, not the structural deformity that causes their symptom, these treatments can often provide only limited success, and often any success is for only short
periods of time. Changes in shoe choices and various types of paddings and other appliances may help, too. For longer-lasting help, we must examine the cause of the deformity. The reason for knowing
the cause is that the type of treatment will vary, depending upon the cause of the complaint. Orthotics help control the causes of certain types of contracted toes, (those caused by flexor
stabilization, for example), but not other types.
There are several surgical methods to correct a hammer toe. Your physician will decide which method will be most beneficial to you depending on the severity of your deformity, the direction the toe
is deviating and the length of the affected toe. Some common surgical methods include. Arthroplasty. To promote straightening, half of the joint located directly underneath the crooked part of the
toe is removed. Arthrodesis (fusion) To promote straightening, the joint directly underneath where the toe is crooked is completely removed. A wire or pin is inserted to aid healing. Tendon transfer.
Performed alone or in combination with other procedures, a surgeon will take tendons from under the toe and ?re-route? them to the top of the toe to promote straightening. Basal phalangectomy.
Performed to assist patients with severe stiffness, this procedure removes the base of the bone underneath the toe. Weil osteotomy. Performed to assist patients with severe stiffness, this procedure
involves shortening the metatarsal bone and inserting surgical hardware to aid healing.
Certain exercises such as moving and stretching your toe gently with your hands and picking up small or soft objects such as marbles or towels can keep your toe joints flexible, simple exercises can
stretch and strengthen your muscles. Limit high-heel use, well-designed flat shoes will be more comfortable than high heels. Don't wear shoes that are too short or too narrow, or too shallow, this is
especially important for children going through periods of rapid growth, the toe area should be high enough so that it doesn't rub against the top of your toes.