most commonly affects the second toe on the foot. It causes the middle joint to bend.
Hammertoe is most frequently caused by structural problems in the toe or from wearing poor fitting shoes. It is important to diagnose and treat hammertoe early because the condition tends to become
worse over time. If left untreated, hammertoe can require surgery.
Shoes that narrow toward the toe may make your forefoot look smaller. But they also push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of
corns and calluses, which further aggravate the condition. A higher heel forces the foot down and squishes the toes against the shoe, increasing the pressure and the bend in the toe. Eventually, the
toe muscles become unable to straighten the toe, even when there is no confining shoe.
Some people never have troubles with hammer toes. In fact, some people don't even know they have them. They can become uncomfortable, especially while wearing shoes. Many people who develop symptoms
with hammer toes will develop corns, blisters and pain on the top of the toe, where it rubs against the shoe or between the toes, where it rubs against the adjacent toe. You can also develop calluses
on the balls of the feet, as well as cramping, aching and an overall fatigue in the foot and leg.
The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe hammertoes
points in the opposite direction (plantar flexed). Toes may appear crooked or
rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at the tip of
the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still flexible or not.
It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the involved joints, as well
as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.
Non Surgical Treatment
There are several treatment options. These are based on how severe the problem has become. The sooner a person seeks treatment, the more options that person may have. Wear properly fitting shoes;
this does not necessarily mean expensive shoes. Padding any prominent areas around the bony point of the toe may help to relieve pain. Medication that reduces inflammation can ease the pain and
swelling. Sometimes a doctor will use cortisone injections to relieve acute pain. A podiatrist may also custom-make an insert to wear inside your shoe. This can reduce pain and keep the hammer toe
from getting worse. Your doctor may recommend foot exercises to help restore muscle balance. Splinting the toe may help in the very early stages.
Your podiatrist may recommend a surgical procedure if your hammertoes are not helped by the conservative care methods listed above. Surgery for hammertoes is performed to help straighten your crooked
toe. Your surgery will be performed in your podiatrist?s office or at a hospital, depending on the severity of your hammertoe. A metal pin is sometimes used to help your affected toe maintain its
straight position during your recovery.