OverviewHammer toes is caused when the middle joint (PIP) bends down towards the floor (flexion). To compensate, the joints above and below (MTP, DIP) bend up (hyperextend). The result is that the middle part of the toe lifts up. Hammertoe is the most common deformity of the lesser toes (i.e. not the big toe). It tends to only affect one toe, most commonly the second.
Causes
Though hammer toes are principally hereditary, several other factors can contribute to the deformity. Most prevalent is an imbalance of the muscles and tendons that control the motion of the toe. When the tendon that pulls the toe upward is not as strong as the one that pulls it downward there is a disparity of power. This forces the toe to buckle and gradually become deformed. If the it persists, the toe can become rigid and harder to correct.
Symptoms
The middle joint of the toe is bent. The end part of the toe bends down into a claw-like deformity. At first, you may be able to move and straighten the toe. Over time, you will no longer be able to move the toe. It will be painful. A corn often forms on the top of the toe. A callus is found on the sole of the foot. Walking or wearing shoes can be painful.
Diagnosis
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe.
Non Surgical Treatment
Apply a commercial, nonmedicated hammertoe pad around the bony prominence of the hammertoe. This will decrease pressure on the area. Wear a shoe with a deep toe box. If the hammertoe becomes inflamed and painful, apply ice packs several times a day to reduce swelling. Avoid heels more than two inches tall. A loose-fitting pair of shoes can also help protect the foot while reducing pressure on the affected toe, making walking a little easier until a visit to your podiatrist can be arranged. It is important to remember that, while this treatment will make the hammertoe feel better, it does not cure the condition. A trip to the podiatric physician?s office will be necessary to repair the toe to allow for normal foot function. Avoid wearing shoes that are too tight or narrow. Children should have their shoes properly fitted on a regular basis, as their feet can often outgrow their shoes rapidly. See your podiatric physician if pain persists.
Surgical Treatment
If pinning the toe is not required during the procedure, then the surgery could be preformed in the doctor's office under a local anesthesia. Some patients prefer the comfort of sedation during the surgery and if this is the case or if a pin must be placed, then the surgery could be preformed in an outpatient surgery center.
Prevention
Avoid wearing shoes that are too short or narrow. Check children's shoe sizes often, especially during periods of fast growth. If you have hammer toe, call for an appointment with your health care provider. If you develop thick blisters or corns on your toes, if your pain gets worse, if you have difficulty walking call for an appointment with your health care provider.