The name Hammer toe
comes from the way the tip of the toe hits or hammers on the floor with each step. The
primary deformity seen in a hammer toe is found at the PIPJ (proximal interphalangeal joint) which is the first or more proximal of the two joints of the toe. A mallet toe, on the other hand, is a
similar deformity but is found in the DIPJ (distal interphalangeal joint). And lastly, claw toes are a deformity where the hammertoes
entire toe grabs and involves the MPJ (metatarsal phalangeal joint) PIPJ and DIPJ. Collectively,
these deformities are referred to as hammer toes. Hammer toes can affect one or all of the toes simultaneously.
Hammer toe usually affects the second toe. However, it may also affect the other toes. The toe moves into a claw-like position. The most common cause of hammer toe is wearing short, narrow shoes that
are too tight. The toe is forced into a bent position. Muscles and tendons in the toe tighten and become shorter. Hammer toe is more likely to occur in women who wear shoes that do not fit well or
have high heels and children who keep wearing shoes they have outgrown. The condition may be present at birth (congenital) or develop over time. In rare cases, all of the toes are affected. This may
be caused by a problem with the nerves or spinal cord.
People with a hammer toe will often find that a corn or callus will develop on the top of the toe, where it rubs against the top of the footwear. This can be painful when pressure is applied or when
anything rubs on it. The affected joint may also be painful and appear swollen.
Hammer toes may be easily detected through observation. The malformation of the person's toes begin as mild distortions, yet may worsen over time - especially if the factors causing the hammer toes
are not eased or removed. If the condition is paid attention to early enough, the person's toes may not be permanently damaged and may be treated without having to receive surgical intervention. If
the person's toes remain untreated for too long, however the muscles within the toes might stiffen even more and will require invasive procedures to correct the deformity.
Non Surgical Treatment
Hammer toes usually get progressively worse over time, especially if you avoid seeking care. Not all cases are the same, so it is important to get your podiatrist or foot surgeon to evaluate your
condition so that you can get the treatment you need as soon as possible. Your treatment options will vary depending on the severity of your hammer toe. You may not require surgery to treat your
hammer toe. Your doctor may suggest one of these less invasive measures. Instead of wearing shoes that are too high or too short, wear comfortable shoes that have plenty of room and are flat or
low-heeled. Your doctor can prescribe pads that will prevent your corns or calluses from getting irritated. Avoid over-the-counter medicated pads, as they contain acid that can worsen your condition.
An orthotic device can be customized to fit your shoe and foot. It can help control your tendon and muscle imbalance, which in turn may ease your pain. NSAIDS (nonsteroidal anti-inflammatory drugs)
such as ibuprofen can reduce inflammation. By relieving swelling in your toe joint, you can alleviate your pain. Splints or small straps can be placed on your toe by a foot surgeon to realign your
bent toe. Applying ice packs wrapped in cloth on your hammer toe can reduce inflammation and swelling. Gently massaging your toes can assist in alleviating your pain caused by hammer toes. Try
exercises that stretch your feet as these can help restore your muscle balance. A simple exercise that can help is to pick up a cloth or small object from the floor by curling your toes. This action
will help your feet and toes by stretching them.
If conservative treatments fail and your symptoms persist, the doctor may recommend a surgical option to straighten the toe. The procedures used vary greatly, depending upon the reasons for the
hammertoe. There are a number of different operations to correct hammertoes, the most common ones involve Soft tissue corrections such as tendon transfers, tendon lengthening, and joint capsule
repairs. Digital arthroplasty involves removal of bone from the bent joint to allow the toe to straighten. The temporary use of pins or K-wires may be necessary to keep the toe straight during the
healing period. Joint implants are sometimes used to allow for a better range of motion in the toe following surgery. Digital arthrodesis involves the removal of bone from the bent joint and fusing
the toe in a straight position. If the corn is due to a bone spur, the most common procedure used is an exostectomy, in which surgically removing it or filing it down removes the bone spur. Because
of the possible complications involved with any surgery, one should be sure to understand the risks that may be involved with surgery to correct hammertoes and remove bone spurs.
To help prevent hammer toes from developing, wear shoes or boots that provide sufficient width in the toe box to ensure minimal compression. Use inserts that help the toes flatten out and spread and
give sufficient support to the metatarsal arch in the forefoot. If hammer toes have already formed, padded socks help protect the tops and the tips of the hammer toes and may reduce pain from rubbing