What are Hammertoes?

· A hammertoe is a contracture — or bending — of one or both joints of the toe which puts pressure on the toe when wearing shoes


Symptoms of Hammertoes include:

· Pain or irritation of the affected toe when wearing shoes.

· Corns (a buildup of skin) on the top, side, or end of the toe, or between two toes. Corns are caused by constant friction against the shoe. They may be soft or hard, depending upon their location.

· Callouses (another type of skin buildup) on the bottom of the toe or on the ball of the foot.

· The toe joints may become dislocated and the toes may overlap.

· Hammertoes usually start out as mild deformities and get progressively worse over time.



 What Causes Hammertoes?

· A muscle/tendon imbalance which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people.

· Hammertoes are often aggravated by shoes that don’t fit properly–for example, shoes that crowd the toes.

· Ill-fitting shoes can actually cause the bending that defines hammertoe. For example, a hammertoe may develop if a toe is too long and is forced into a cramped position when a tight shoe is worn. In some people, hammertoes are inherited.

· In the earlier stages, hammertoes are flexible and the symptoms can often be managed with conservative care.

· If left untreated, hammertoes can become more rigid and will not respond to non-surgical treatment.

· In more severe cases of hammertoe, open sores may form.

· Because of their progressive nature, hammertoes should receive early attention. Hammertoes never get better without some kind of treatment.


Non-Surgical Treatment:

· Trimming corns and callouses. This should be done by a podiatrist or chiropodist. Never attempt  to do this yourself since you run the risk of cuts and infection. Your Foot Specialist knows the proper way to soften and trim corns to bring you the greatest benefit.

· Padding corns and callouses. Your Foot Specialist can provide or prescribe pads designed to shield corns from irritation. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful and lead to open sores.

· Footwear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels–conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toe box and heels no higher than two inches.

· Custom Orthotics. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance and decrease the rate of progression of this deformity.

· Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation

· Medications. Drugs called NSAIDs are occasionally used to treat inflamed toes.

· Splinting/strapping. Splints or small straps are fashioned to realign the bent toe.


When Is Surgery Needed?


· Surgery may be needed to relieve the pain and discomfort caused by your hammertoe.

· The most common surgical procedure is arthroplasty. In this procedure, the surgeon removes a small section of the bone from the affected joint.

· Another surgical option is fusing of one or both toe joints, which is usually reserved for more rigid toes.  This straightens the bent toe. A pin is usually used to hold the toe in position while the bones are healing.

· Other procedures may be required including tendon/muscle rebalancing or lengthening.

· Depending on the procedure, you may be able to immediately walk after your hammertoe surgery in a special surgical shoe.