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 hammertoe
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.
The cause of hammertoes varies, but causes include genetics, arthritis and injury to the toe. Treatment for hammertoes depends on the severity and can include anti-inflammatory medication, metatarsal
pads, foot exercises and better-fitting shoes. If the pain caused by a hammertoe is so severe that wearing a shoe is uncomfortable, surgery may be necessary. Typically this surgery is an outpatient
procedure that doesn?t require general anesthesia, though it is an option. Recovery from surgery usually takes a few weeks, and patients are given special shoes to wear.
A soft corn, or heloma molle, may exist in the web space between toes. This is more commonly caused by an exostosis, which is basically an extra growth of bone possibly due to your foot structure. As
this outgrowth of excessive bone rubs against other toes, there is friction between the toes and a corn forms for your protection.
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
People with a hammer toe benefit from wearing shoes in which the toe box is made of a flexible material and is wide enough and high enough to provide adequate room for the toes. High-heeled shoes
should be avoided, because they tend to force the toes into a narrow, flat toe box. A doctor may recommend an insert (orthotic) for the hammertoes
shoe to help reduce friction and pressure on the hammer toe. Wearing properly fitted shoes may reduce
pain and inflammation. It may also prevent ulcers from developing and help existing ulcers heal. However, the hammer toe does not disappear.
Toe Relocation procedures are ancillary procedures that are performed in conjunction with one of the two methods listed about (joint resection or joint mending). When the toe is deformed (buckled) at
the ball of the foot, then this joint often needs to be re-positioned along with ligament releases/repair to get the toe straight. A temporary surgical rod is needed to hold the toe aligned while the
Daily modifications and correct shoe choices can prevent and slow the progression of hammertoe deformities. The main cause in hammertoe deformities is muscle/tendon dysfunction. Wearing of
ill-fitting, tight, high heeled shoes contributes to the progression to hammertoe deformities. Also, bunion conditions can enhance the formation of hammertoes. A key to prevention of hammertoes is
the wearing of correct footwear, specifically shoes with appropriate support and a deep, wide toe box.