The term hammertoe refers to a common deformity of the foot in which either the second, third, or fourth toe is bent at the middle joint, so that the tip of the toe is bent downward while the middle of the toe is cocked upward resembling a hammer. The hammer toe deformity is the most common deformity of the small toes. When a hammer toe first develops, it can be bent back into its normal position. If not treated, a hammer toe may become rigid and require surgical correction in order to correct the deformity. Symptoms and signs associated with hammer toe include corns or calluses on the affected toe and pain in the affected area. It may be difficult for people suffering from hammer toe to find comfortable shoes.
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.
The middle joint of the toe is bent. The end part of the toe bends down into a claw-like deformity. At first, you may be able to move and straighten the toe. Over time, you will no longer be able to move the toe. It will be painful. A corn often forms on the top of the toe. A callus is found on the sole of the foot. Walking or wearing shoes can be painful.
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.
Non Surgical Treatment
Conservative treatment is limited to accommodation, not correction, of the deformity, though some patients find the relief they can get from these options to be more than enough to put off or even avoid surgery. These include better Footwear. Shoe gear with a wider toe box and higher volume causes less friction to the toes. Toe Braces and Strapping. Some toe braces and strapping techniques take some pressure off the toes during gait. Custom molded orthotics can redistribute the forces through the tendons that control the toe, lessening the pain and hammertoe extent of the deformity.The calluses on the toe and the ball of the foot can be shaved occasionally to reduce some pain and pressure, although they will return due to the constant deformity.
Surgery to correct for a hammertoe may be performed as a day procedure. There are several different types of procedures that can be used depending on the foot structure and if the deformity is flexible or rigid.
Custom orthotics paired with a well made shoe can prevent the progression and development of hammertoes. Wearing proper-fitting shoes and custom orthotic devices can provide the support patients need to address muscle/tendon dysfunction. It can also support end stage diseases that result in hammertoe deformities by re-balancing the foot and ankle and controlling the deforming forces.