Hammertoes

What is a hammertoe?

Hammertoe is a contracture, or bending, of one or both joints of the lesser toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop. Common symptoms of hammertoes include:

1. Pain or irritation of the affected toe(s) when wearing shoes
2. Corn/callous (a build-up of skin) on the top, side, or end of the toe, or between two toes. Corns are caused by constant friction against the toe.

Progression

Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are usually flexible and can often be managed with non-invasive measures. If left untreated, hammertoes can become more rigid and may require surgery. Corns are more likely to develop as time goes on; and corns never really go away, even after trimming. In more severe cases of hammertoe, a wound may form.

What causes a hammertoe?

The most common cause of hammertoe is a muscle / tendon imbalance. This imbalance leads to a bending of the toe.

Occasionally, hammertoe is caused by some kind of trauma, such as a previously broken toe. There is a genetic component to hammertoes similar to bunions.

Treatment: Non-surgical

There are a variety of treatment options for hammertoe. The treatment your foot and anklesurgeon selects will depend upon the severity of your hammertoe and other factors.

A number of non-surgical measures can be undertaken:

1. Trimming corns and calluses. This should be done by a healthcare professional. Never attempt to do this yourself, because you run the risk of cuts and infections.

2. Padding corns and calluses. Your foot and ankle specialist can provide or prescribe pads designed to shield corns from irritation. If you want to try over-the-counter pads, avoid the medicated types as these might cause more problems. Consult your foot and ankle doctor about this option.

3. Changes in shoegear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels. Instead, choose comfortable shoes with deep, roomy toe boxes and no heels.

4. Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance.

5. Splinting/strapping. Splints or small straps may be applied by the foot and ankle specialist to re-align the bent toe.

When is surgery needed?

In some cases, usually when the hammertoe has become more rigid, surgery is needed to relieve the pain and discomfort caused by the deformity. Your foot and ankle surgeon will discuss the options and select a plan tailored to your needs. There are many factors that go into making this decision.

The most common surgical procedure performed to correct a hammertoe is called arthroplasty. In this procedure, the surgeon removes a small section of the bone from the affected joint. Another surgical option is arthrodesis, which is usually reserved for more rigid toes or severe cases, such as when there are multiple joints or toes involved. Arthrodesis is a procedure that involves a fusing of a small joint in the toe to straighten it. A pin or other small fixation device is typically used to hold the toe in position while the bones are healing.

It is possible that a patient may require other procedures, as well - especially when the hammertoe condition is severe.

Often patients with hammertoe may have bunions or other foot deformities corrected at the same time. The length of the recovery period will vary, depending on the procedure or procedures performed. We perform our procedures in an outpatient setting.

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