Hammertoes are another forefoot deformity that can take a walker out of their activity. A Hammer toes
generally represent a tendon imbalance in the toes caused by one of the toe
tendons getting an advantage over another toe tendon. Most commonly, it is one or all of the long extensor tendons on the top of the foot that gets an advantage over one or all of the flexor tendons
on the bottom of the foot, to cause the first joint in the toe to be elevated above the ground. Most shoe wearing people chronically alter the delicate balance that co-exists amongst the toe tendons
whether they know it or not.
Claw, hammer and mallet toe are most commonly caused by wearing high heels or ill-fitting shoes that are too tight e.g. narrow toebox. If shoes like this are worn for long periods, the foot is held
in a slightly bent position and gradually over time, the muscles tighten and shorten. If this continues for long enough, then the muscles become so tight that even when shoes are removed, the toe is
still held in the bent position. Another common cause is Morton?s Toe, where the second toe is longer than the big toe. In this case, the second toe is commonly squashed into a shoe into an
unnaturally bent position.
The most common symptoms of hammertoes include. The toe is bent upward at the middle toe joint, so that the top of this joint rubs against the top of the shoe. The remainder of the toe is bent
downward. 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
the toe joint. Pain in the ball of the foot at the base of the affected toe. This occurs because the contracted digit puts pressure on the metatarsal head creating callouse and pressure on the ball
of the foot.
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
Many people start by treating the problem themselves when they have a painful corn or callus. They try to remove the corn by cutting it off or by applying strong acids, and they try to cushion the
toe by applying cushioned pads. Because these treatments can be difficult to perform by oneself (and should never be done by oneself when the patient is diabetic or circulation is poor), and because
these treatments only treat the symptom, not Hammer toes
the structural deformity that causes their symptom, these treatments can
often provide only limited success, and often any success is for only short periods of time. Changes in shoe choices and various types of paddings and other appliances may help, too. For
longer-lasting help, we must examine the cause of the deformity. The reason for knowing the cause is that the type of treatment will vary, depending upon the cause of the complaint. Orthotics help
control the causes of certain types of contracted toes, (those caused by flexor stabilization, for example), but not other types.
Treatment of a severe hammertoe that has become rigid includes surgery. What is done during the surgery depends on how misshapen and inflexible the toe is. The surgeon may make a cut over your toe
and release the tendon by cutting the tendon away from the bone. The surgeon may remove a small piece of bone from the toe. The surgeon may realign the tendons to reposition your toe or fasten the
bones with pins. Sometimes the surgeon may have to join the bones in the toe. In this case, you will no longer be able to bend the toe, but the toe will be flat.