Hammer Toe Deformity

A hammer toe is a toe deformity affecting the lesser toes, with the toe curling around to take on the shape of a claw or hammer. The bend in the toe takes place at the first interphalangeal joint in the middle of the toe, with the joint moving upwards. The problem can be genetic but is most commonly caused by wearing improper shoes with a restrictive toe box, with accompanying high heels likely to increase the speed at which the condition develops.
Whilst in adults it is footwear choice which most commonly leads to the formation of hammer toes, the condition can also occur in children. Whilst structural abnormalities n the feet can be the cause, in children most commonly it is a child’s foot outgrowing footwear which is the cause. Children’s feet grow at a fast rate, and it is important to periodically check that shoes still fit properly and give the toes room to move.
Footwear may be the most common cause, but hammer toes can develop for other reasons. Any condition or disease which affects the muscles or nerves can make hammer toe formation more likely. The condition has been linked to strokes, diabetes, osteoarthritis and rheumatoid arthritis.


Hammer Toe Symptoms

Naturally the most obvious symptom is a bend which appears in the toe at the first interphalangeal joint in the middle of the toe. The toe bends upwards at this joint, with the end of the toe curling round in a claw or hammer shape. However, there are other symptoms commonly associated with hammer toe development such as the formation of foot corns and calluses on top of the toes, with the hard skin forming due to friction from footwear. There may also be accompanying toe joint pain, with the joint lining becoming inflamed in a condition termed bursitis. There may also be discomfort when walking due to the deformity, and if the underlying cause of hammer toe formation is not addressed, the problem may spread to other toes, or the distal joint of the same toe.

Hammer Toe Treatment

If hammertoe is spotted and treatment begins early, the patient can recover by simple procedures. However, if the condition of the toe is not good and the disease has continued for some time surgery may be the best course of action. Initially, correction of hammer toes uses conservative methods to encourage the toes to move back into proper alignment. Restrictive footwear needs to be changed to shoes with a wide toe box to reduce any undue pressure on the toes. Toe straightening devices are often the primary treatment method. These devices are typically worn at night, although can be worn whenever the foot is at rest. They stretch your feet in a way that gradually encourages them back into the right position. Some devices are designed for wear with shoes, for round the clock correction.
Toe exercises can be highly beneficial and can encourage more flexibility in the toes, and will gently stretch out the tendons and ligaments. In the initial stages of development, exercises along may be enough to treat the problem.

If hammer toes are allowed to progress, and conservative treatments prove to be ineffective, hammer toe surgery is the last resort. Hammer toe surgery is not a complicated procedure and it takes only a few hours and is completed with a local anesthetic on an outpatient basis. Tendons are cut to allow proper alignment, and bones may be shaved or partially removed to get the toes back into proper alignment. The toes may be pinned in place temporarily whilst recovering from surgery, until the bones set.