is a deformity of the second, third or fourth toes in which
the main toe joint is bent upward like a claw. Initially, hammertoes are flexible and can be corrected with simple measures. Left untreated, they can become fixed and require surgery. Hammertoe
results from shoes that don?t fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is bent and
held in one position long enough, the muscles tighten and can?t stretch out.
Wearing ill-fitting shoes is probably the main cause of hammer toe. As the toe bends, tendons add to the problem by contracting in such a way that the bending is reinforced to the point of becoming
permanent. In some cases, tendons that are abnormal to begin with may start the bending process.
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 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
A person with hammer toes will be asked to practice some exercises for their toes to regain average structure and movement. The exercises usually involve stretching and strengthening their toes. The
person may attempt to Hammer toe
pick things up off the floor using only their toes. They may also
stretch their toes on a regular basis by hand to ease them into straightening out. Another example of a physical exercise specifically for a person's toes involves crumpling a towel with the toes.
The towel can lie underneath the person's feet and the person can use their toes to scrunch up the towel as they perform simple tasks such as reading a book or watching television.
Surgery to straighten the toe may be needed if an ulcer has formed on either the end or the top surface of the toe. Surgery sometimes involves cutting the tendons that support movement in the toe so
that the toe can be straightened. Cutting the tendons, however, takes away the ability to bend the very end of the toe. Another type of surgery combines temporary insertion of a pin or rod into the
toe and alteration or repair of the tendons, so that the toe is straightened. After surgery, the deformity rarely recurs.