A Hammer toes
is a deformity of the second, third or fourth toes. In this
condition, the toe is bent at the middle joint, so that it resembles a hammer. Initially, hammer toes are flexible and can be corrected with simple measures but, if left untreated, they can become
fixed and require surgery. People with hammer toe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have
difficulty finding comfortable shoes.
While most cases of hammertoes are caused by an underying muscle imbalance, it may develop as a result of several different causes, including arthritis, a hereditary condition, an injury, or
ill-fitting shoes. In some cases, patients develop hammertoes after wearing shoes or stockings that are too tight for long periods of time. These patients usually develop hammertoes in both
A hammertoe may be present but not always painful unless irritated by shoes. One may have enlarged toe joints with some thickened skin and no redness or swelling. However, if shoes create pressure on
the joint, the pain will usually range from pinching and squeezing to sharp and burning. In long standing conditions, the dislocated joints can cause the pain of arthritis.
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 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 Hammer toe
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
Symptomatic treatment of hammertoes consists of such things as open toed shoes or hammertoe pads. There are over the counter corn removers for temporally reducing the painful callous often seen with
the hammertoe. These medications must be used with caution. They are a mild acid that burns the callous off. These medications should never be used for corns or callouses between the toes. Persons
with diabetes or bad circulation should never use these products.
The technique the surgeon applies during the surgery depends on how much flexibility the person's affected toes still retain. If some flexibility has still been preserved in their affected toes, the
hammer toes might be corrected through making a small incision into the toe so the surgeon can manipulate the tendon that is forcing the person's toes into a curved position. If, however, the
person's toes have become completely rigid, the surgeon might have to do more than re-aligning the person's tendons. Some pieces of bone may have to be removed so the person's toe has the ability to
straighten out. If this is the case, some pins are attached onto the person's foot afterwards to fix their bones into place while the injured tissue heals.