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HammerToes

HammertoeOverview
A Hammertoes is a deformity that causes your toe to bend or curl downward instead of pointing forward. This deformity can affect any toe on your foot; however, it most often affects the second toe or third toe. Although a hammertoe may be present at birth, it usually develops over time due to wearing ill-fitting shoes or arthritis. In most cases, a hammertoe is treatable.


Causes
People who have a high-arched feet have an increased chance of hammer toes occurring. Also, patients with bunion deformities notice the second toe elevating and becoming hammered to make room for the big toe that is moving toward it. Some patients damage the ligament that holds the toe in place at the bottom of the joint that connects the toe and foot. When this ligament (plantar plate) is disrupted or torn, the toe floats upward at this joint. Hammer toes also occur in women wearing ill-fitting shoes or high heels, and children wearing shoes they have outgrown.

Hammer Toe

Symptoms
People who have painful hammertoes visit their podiatrist because their affected toe is either rubbing on the end their shoe (signaling a contracted flexor tendon), rubbing on the top of their shoe (signaling a contracted extensor tendon), or rubbing on another toe and causing a painful buildup of thick skin, known as a corn.


Diagnosis
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe. If the deformed toe is very painful, your doctor may recommend that you have a fluid sample withdrawn from the joint with a needle so the fluid can be checked for signs of infection or gout (arthritis from crystal deposits).


Non Surgical Treatment
Any forefoot problems that cause pain or discomfort should be given prompt attention. Ignoring the symptoms can aggravate the condition and lead to a breakdown of tissue, or possibly even infection. Conservative treatment of mallet toes begins with accommodating the deformity. The goal is to relieve pressure, reduce friction, and transfer forces from the sensitive areas. Shoes with a high and broad toe box (toe area) are recommended for people suffering from forefoot deformities such as mallet toes. This prevents further irritation in the toe area from developing. Other conservative treatment includes forefoot supports such as gel toe caps, gel toe shields and toe crests. Gel forefoot supports provide immediate comfort and relief from common forefoot disorders without drying the skin.


Surgical Treatment
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.

Hammer Toe

Prevention
Most cases of hammertoe can be prevented by wearing shoes that fit properly and give the toes plenty of room. Some recommended guidelines include avoid shoes with pointed or narrow toes. Avoid shoes that are too tight or short. Avoid high-heeled shoes, which can force the toes forward. If the shoes hurt, don’t wear them. Choose shoes with wide or boxy toes. Choose shoes that are a half-inch longer than your longest toe.

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