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Hammer Toes

A hammertoe is a contracture, or bending, of the toe at the first joint of the digit, called the proximal interphalangeal joint. This bending causes the toe to appear like an upside-down V when looked at from the side. Any toe can be involved, but the condition usually affects the second through fifth toes, known as the lesser digits. Hammertoes are more common in females than males. Flexible Hammer Toes are less serious because they can be diagnosed and treated while still in the developmental stage. They are called flexible hammertoes because they are still moveable at the joint. Rigid Hammer Toes are more developed and more serious than the flexible condition. Rigid hammertoes can be seen in patients with severe arthritis, for example, or in patients who wait too long to seek professional treatment. The tendons in a rigid hammertoe have become tight, and the joint misaligned and immobile, making surgery the usual course of treatment.

A hammertoe develops because of an abnormal balance of the muscles in the toes. This abnormal balance causes increased pressures on the tendons and joints of the toe, leading to its contracture. Heredity and trauma can also lead to the formation of a hammertoe. Arthritis is another factor, because the balance around the toe in people with arthritis is disrupted. Wearing shoes that are too tight and cause the toes to squeeze can also cause a hammertoe to form.

The symptoms of a hammertoe include:

  • Pain at the top of the bent toe upon pressure from footwear
  • Formation of corns on the top of the joint
  • Redness and swelling at the joint contracture
  • Restricted or painful motion of the toe joint
  • Pain in the ball of the foot at the base of the affected toe

If pain persists, come in and see our podiatrist. If left untreated, hammer toes tend to become rigid, making non-surgical treatment less of an option. The treatment options vary with the type and severity of each hammertoe, although identifying the deformity early in its development is important to avoid surgery. Our podiatrist will examine and X-ray the affected area and recommend a treatment plan specific to your condition.

Often padding and taping are the first steps in a treatment plan. Padding the hammertoe prominence minimizes pain and allows the patient to continue a normal, active life. Taping may change the imbalance around the toes and thus relieve the stress and pain. Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the joint deformity. Custom shoe inserts made by our podiatrist may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the hammertoe deformity.

Surgical Options: Several surgical procedures are available. For less severe deformities, the surgery will remove the bony prominence and restore normal alignment of the toe joint, thus relieving pain. Severe hammertoes, which are not fully reducible, may require more complex surgical procedures. Recuperation takes time, and some swelling and discomfort are common for several weeks following surgery. Any pain, however, is easily managed with medications prescribed by your podiatrist.

Prevention
There are several things you can do to help prevent hammer toes from forming or progressing:

  • Wear supportive shoes to help prevent deformities. Hammertoes are often related to faulty foot mechanics, especially foot flattening.
  • Wear custom orthotics prescribed by your podiatrist. Orthotics may slow the progression or prevent the development of hammertoes.
  • Avoid shoes with narrow or pointed toe boxes that can compress the toes.

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