is a deformity of the hammertoes
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.
Risk factors for hammertoe include heredity, a second toe that is longer than the first (Morton foot), high arches or flat feet, injury in which the toe was jammed, rheumatoid arthritis, and, in
diabetics, abnormal foot mechanics resulting from muscle and nerve damage. Hammertoe may be precipitated by advancing age, weakness of small muscles in the foot (foot intrinsic muscles), and the
wearing of shoes that crowd the toes (too tight, too short, or with heels that are too high). The condition is more common in females than in males.
The symptoms of a hammer toe are usually first noticed when a corn develops on the top of the toe and becomes painful, usually when wearing tight shoes. There may be a bursa under the corn or instead
of a corn, depending on the pressure. Most of the symptoms are due to pressure from footwear on the toe. There may be a callus under the metatarsal head at the base of the toe. Initially a hammer toe
is usually flexible, but when longstanding it becomes more rigid.
The earlier a hammertoe is diagnosed, the better the prognosis and treatment options. Your doctor will be able to diagnose your hammertoe with a simple examination of the foot and your footwear. He
or she may take an x-ray to check the severity of the condition. You may also be asked about your symptoms, your normal daily activities, and your medical and family history.
Non Surgical Treatment
Conservative treatment is the first choice, often starting with a change of shoes to ones that have soft, larger toe spaces. Toe exercises may be prescribed to stretch and strengthen the toe muscles.
Over-the-counter straps, cushions or non-medicated corn pads may be recommended to help relieve your symptoms.
If these treatments are not sufficient at correcting the hammer toe, an operation to straighten the toe may be necessary. This is often performed in conjunction with surgery for a bunion deformity.
The surgical treatment of a hammer toe can consist of either cutting the tendons to relieve the pressure that causes the deformity, or fusing the toe so that it points straight permanently.
Although the feet naturally change over time, and abnormalities like hammertoes may be hereditary for some patients, steps may be taken to prevent their development in the first place. Just as better
fitting shoes are a treatment, they are also a preventative measure for hammertoes. In addition, your podiatrist may suggest orthotics to improve the biomechanics of your feet in an effort to prevent
the development of hammertoes or other abnormalities. Calf stretching and other exercises may also be used to reverse or treat muscle imbalances that could eventually lead to hammertoe development.