Hammer toes are classified based on the mobility of the toe joints. There are two types. Flexible and rigid. In a flexible hammertoes
, the joint has the ability to move. This type of hammer toe can be straightened manually. A rigid
hammer toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become restricted leading to extra stress at the
ball-of-the-foot, and possibly causing pain and the development of corns and calluses.
Though hammer toes are principally hereditary, several other factors can contribute to the deformity. Most prevalent is an imbalance of the muscles and tendons that control the motion of the toe.
When the tendon that pulls the toe upward is not as strong as the one that pulls it downward there is a disparity of power. This forces the toe to buckle and gradually become deformed. If the it
persists, the toe can become rigid and harder to correct.
The most obvious symptom of hammertoe is the bent, hammer-like or claw-like appearance of one or more of your toes. Typically, the proximal joint of a toe will be bending upward and the distal joint
will be bending downward. In some cases, both joints may bend downward, causing the toes to curl under the foot. In the variation of mallet toe, only the distal joint bends downward. Other symptoms
may include Pain and stiffness during movement of the toe, Painful corns on the tops of the toe or toes from rubbing against the top of the shoe's toe box, Painful calluses on the bottoms of the toe
or toes, Pain on the bottom of the ball of the foot, Redness and swelling at Hammer toes
the joints. If you
have any of these symptoms, especially the hammer shape, pain or stiffness in a toe or toes, you should consider consulting your physician. Even if you're not significantly bothered by some of these
symptoms, the severity of a hammertoe can become worse over time and should be treated as soon as possible. Up to a point hammertoes can be treated without surgery and should be taken care of before
they pass that point. After that, surgery may be the only solution.
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.
Non Surgical Treatment
Symptomatic treatment of hammertoes consists of such things as open toed shoes or hammertoe pads. There are over the counter corn removers for temporally reducing the painful callous often seen with
the hammertoe. These medications must be used with caution. They are a mild acid that burns the callous off. These medications should never be used for corns or callouses between the toes. Persons
with diabetes or bad circulation should never use these products.
There are several surgical methods to correct a hammer toe. Your physician will decide which method will be most beneficial to you depending on the severity of your deformity, the direction the toe
is deviating and the length of the affected toe. Some common surgical methods include. Arthroplasty. To promote straightening, half of the joint located directly underneath the crooked part of the
toe is removed. Arthrodesis (fusion) To promote straightening, the joint directly underneath where the toe is crooked is completely removed. A wire or pin is inserted to aid healing. Tendon transfer.
Performed alone or in combination with other procedures, a surgeon will take tendons from under the toe and ?re-route? them to the top of the toe to promote straightening. Basal phalangectomy.
Performed to assist patients with severe stiffness, this procedure removes the base of the bone underneath the toe. Weil osteotomy. Performed to assist patients with severe stiffness, this procedure
involves shortening the metatarsal bone and inserting surgical hardware to aid healing.