The term, Hammer toes
, is commonly used as hammertoes
a general classification
for any condition where the toe
muscle weakens, causing digital contracture, and resulting in deformity, a digital contracture like this can actually be a hammertoe, claw toe
or mallet toe
, depending on which joints in the toe
are contracted. Clawtoes are bent at the middle and end joints, while hammertoes are bent at the middle joint only. When it?s mallet toe
, the joint at the end of the toe
buckles. The skin near the toenail tip develops a painful corn that can eventually result in an ulcer. Doctors further categorize all forms of hammertoe based on whether the affected toe
is flexible, semi-rigid or rigid. The more rigid the toe
, the more pain it will cause.
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.
(usually the second digit, next to the big toe
) bent at the middle joint and clenched into a painful, clawlike position. As the toe
points downward, the middle joint may protrude upward. A toe
with an end joint that curls under itself. Painful calluses or corns. Redness or a painful corn on top of the bent joint or at the tip of the affected toe
, because of persistent rubbing against shoes Pain in the toes that interferes with walking, jogging, dancing, and other normal activities, possibly leading to gait changes.
Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
Hammer toes may be effectively corrected in different ways. Treatments can be non-invasive and involve physical therapy along with the advice that the person not wear any more shoes that restrict appropriate space for their toes. Appropriate shoes for people who want to avoid hammer toes, or for people who already have them, should be at least half an inch longer than the person's longest toe
. High-heeled shoes are something
to definitely avoid.
Surgical correction is necessary in more severe cases and may consist of removing a bone spur (exostectomy) removing the enlarged bone and straightening the toe
(arthroplasty), sometimes with internal fixation using a pin to realign the toe
; shortening a long metatarsal bone (osteotomy) fusing the toe
joint and then straightening the toe
(arthrodesis) or simple tendon lengthening and capsule
release in milder, flexible hammertoes (tenotomy and capsulotomy). The procedure chosen depends in part on how flexible the hammertoe is.
wear sensible shoes. Here are some tips. Most people have one foot that's bigger than the other. Fit your shoes to the bigger foot. Buy your shoes at the end of the day as your feet tend
to swell a bit and you will get a better sense of fit. When you buy your shoes, wear the sock that you will be using when wearing that shoe - wear a sports sock when buyingtrainers, for example. As you get older, your feet get bigger. Get your feet measured every time you buy shoes. Don't go by shoe sizes. Shoe sizes vary among manufacturers; a shoe is the right size only when it fits comfortably. The ball of your foot should fit into the widest part of the shoe. A shoe should be sturdy so that it only bends in the ball of the foot, exactly where your big toes bend. Any shoe that can be bent anywhere along the sole
or twisted side to side is generally too flimsy. There should be at least 1.5 cm between the tip of your longest toe
and the front of the shoe. Never buy shoes that feel tight and expect them to stretch with wearing. If you have prominent areas on your feet such as hammer toes and bunions, avoid shoes with a lot of stitching or multiple pieces of fabric, as these stitched areas tend
not to stretch to accommodate various toe
deformities. Your shoes shouldn't ride up and down on your heel as you walk. The higher the heel, the less safe the shoe. Check children's shoes regularly.