OverviewHammer toes (hammertoe) is a deformity of the second, third, or fourth toes. In this condition, the toe is bent at the middle joint, into an upward position, causing it to resemble a hammer (sometimes decribed as ?curled toes?). Left untreated, hammer toes can become inflexible and require surgery. Toes which take on a curled appearance are hammer toes. Mallet toe is a similar condition, but affects the upper joint of a toe.
Causes
A common cause of hammer toe is wearing shoes that do not fit properly. Poorly-fitting shoes can hold the toes in an abnormal position and result in tightening of the muscles required to maintain that position. In particular, shoes that have high heels and are narrow at front tend to push the toes into an abnormal, bent position. Less commonly, diseases of the nerves, muscles, or joints (such as arthritis) can result in the hammer toe deformity.
Symptoms
If the toes remain in the hammertoe position for long periods, the tendons on the top of the foot will tighten over time because they are not stretched to their full length. Eventually, the tendons shorten enough that the toe stays bent, even when shoes are not being worn. 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.
Diagnosis
The treatment options vary with the type and severity of each hammer toe, although identifying the deformity early in its development is important to avoid surgery. Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.
Non Surgical Treatment
Mild hammer toe in children can be treated by manipulating and splinting the affected toe. The following changes in footwear may help relieve symptoms. Wear the right size shoes or shoes with wide toe boxes for comfort, and to avoid making hammer toe worse. Avoid high heels as much as possible. Wear soft insoles to relieve pressure on the toe. Protect the joint that is sticking out with corn pads or felt pads. A foot doctor can make foot devices called hammer toe regulators or straighteners for you, or you can buy them at the store. Exercises may be helpful. You can try gentle stretching exercises if the toe is not already in a fixed position. PIcking up a towel with your toes can help stretch and straighten the small muscles in the foot.
Surgical Treatment
If you are unable to flex your toe, surgery is the only option to restore movement. Surgery is used to reposition the toe, remove deformed or injured bone, and realign your tendons. Surgery is normally done on an outpatient basis, so you can return home on the day of your surgery.
