, also called hammer toe, deformity of the second, third, or fourth toe in which the toe is bent
downward at the middle joint (the proximal interphalangeal [PIP] joint), such that the overall shape of the toe resembles a hammer. Most cases of hammertoe involve the second toe, and often only one
or two toes are affected. In rare cases when all the toes are involved, a thorough neurological assessment is necessary to evaluate for underlying nerve or spinal cord problems.
Your shoes, your genetic predisposition, an underlying medical condition or all of these can make you susceptible to developing one of these deformities of the toes. The genes your parents gave you.
When it comes to genetics, the foot type you?re born with predisposes you to developing this type of joint deformity over a lifetime. For many, a flat flexible foot leads to hammertoes as the foot
tries to stabilize against a flattening arch. Those with high arches can also form hammertoes as the extensor tendons overpower the flexors.
Pain upon pressure at the top of the bent toe from footwear. The formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of hammertoe
the toe joint. Pain in the ball of the foot at the base of the affected toe.
First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a
metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in
the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.
Non Surgical Treatment
If your toe is still flexible, your doctor may recommend that you change to roomier and more comfortable footwear and that you wear shoe inserts (orthotics) or pads. Wearing inserts or pads can
reposition your toe and relieve pressure and pain. In addition, your doctor may suggest exercises to stretch and strengthen your toe muscles. These may include picking up marbles or a thin towel off
the floor with your toes.
For the surgical correction of a rigid hammertoe, the surgical procedure consists of removing the damaged skin where the corn is located. Then a small section of bone is removed at the level of the
rigid joint. The sutures remain in place for approximately ten days. During this period of time it is important to keep the area dry. Most surgeons prefer to leave the bandage in place until the
patient's follow-up visit, so there is no need for the patient to change the bandages at home. The patient is returned to a stiff-soled walking shoe in about two weeks. It is important to try and
stay off the foot as much as possible during this time. Excessive swelling of the toe is the most common patient complaint. In severe cases of hammertoe deformity a pin may be required to hold the
toe in place and the surgeon may elect to fuse the bones in the toe. This requires several weeks of recovery.
The best treatment is good prevention! Hammertoe can be prevented by wearing shoes with ample toe room, avoiding high heels, and wearing adjustable shoes to assure a looser fit. When buying shoes,
shop at the end of the day when your feet are swollen from daily activity, try both shoes on to confirm they fit properly, and if necessary, visit a shoe repair store to see if they can stretch your
shoes for a better fit.