Patients and doctors often refer to all forms of toe abnormalities as a hammertoe
. There are in fact four main
forms of toe abnormalities, hammer toes, claw toes, mallet toes and trigger toes. A hammertoe can be best described as an abnormal contraction or "buckling" of a toe. This occurs due to a partial or
complete dislocation of one of the joints that form the toe. As the toe continues to be deformed, it will press up against the shoe and may cause corns.
Hammer toe most frequently results from wearing poorly fitting shoes that can force the toe into a bent position, such as excessively high heels or shoes that are too short or narrow for the foot.
Having the toes bent for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity. This is often found in conjunction with bunions or other foot problem
(e.g., a bunion can force the big toe to turn inward and push the other toes). It can also be caused by muscle, nerve, or joint damage resulting from conditions such as osteoarthritis, rheumatoid
arthritis, stroke, Charcot-Marie-Tooth disease, complex regional pain syndrome or diabetes. Hammer toe hammertoe
can also be found in Friedreich's ataxia.
If you have any of these symptoms, do not assume it is due to hammer toe. Talk to your doctor about symptoms such as a toe that curls down, corns on the top of a toe, calluses on the sole of the foot
or bottom of the toe, pain in the middle joint of a toe, discomfort on the top of a toe, difficulty finding any shoes that fit comfortably, cramping in a toe, and sometimes also the foot and leg,
difficult or painful motion of a toe joint, pain in the ball of the foot or at the base of a toe.
A hammertoe is usually diagnosed with a physical inspection of your toe. Imaging tests, such as X-rays, may be ordered if you have had a bone, muscle, or ligament injury in your toe.
Non Surgical Treatment
Hammertoes that are not painful (asymptomatic) and still flexible may not require treatment. In mild cases, open-toed, low-heeled, or wider shoes and foam or moleskin pads can provide symptomatic
relief by reducing pressure. Taping (strapping) the affected toe can help to reduce deformity and pain. Physical therapy to instruct patients in exercises that passively stretch tight structures and
strengthen weak foot intrinsic muscles is also helpful with mild cases. Periodic trimming (debridement) of corns (clavi, helomata) by a podiatrist can provide temporary relief. Corticosteroid
injections are often very effective in reducing pain.
If your hammer, claw, or mallet toe gets worse, or if nonsurgical treatment does not help your pain, you may think about surgery. The type of surgery you choose depends on how severe your condition
is and whether the toe joint is fixed (has no movement) or flexible (has some movement). A fixed toe joint often requires surgery to be straightened. A flexible toe joint can sometimes be
straightened without surgery. Surgery choices include Phalangeal head resection (arthroplasty), in which the surgeon removes part of the toe bone. Joint fusion (arthrodesis), in which the surgeon
removes part of the joint, letting the toe bones grow together (fuse). Cutting supporting tissue or moving tendons in the toe joint. How well surgery works depends on what type of surgery you have,
how experienced your surgeon is, and how badly your toes are affected.