Many disorders can affect the joints in the toes, causing pain and preventing the foot from functioning as it should. A hammertoes
occurs when the joint at the end of the toe cannot straighten. Excessive rubbing of the hammer toe against
the top of the shoe can lead to pain and the development of a corn. The tip of the toe is often turned down against the shoe causing pressure and discomfort.
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 middle joint of the toe is bent. The end part of the toe bends down into a claw-like deformity. At first, you may be able to move and straighten the toe. Over time, you will no longer be able to
move the toe. It will be painful. A corn often forms on the top of the toe. A callus is found on the sole of the foot. Walking or wearing shoes can be painful.
The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear
crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at
the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still
flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the
involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.
Non Surgical Treatment
Wear sensible shoes. If you don?t want to have surgery to fix your hammertoe, use non-medicated padding along with proper shoes made with a wider and deeper toe box to accommodate your foot?s shape.
Ensuring your shoes have a good arch support can slow the progression of the condition as well. Use a pumice stone. The corn or callus that forms on top of the hammertoe can cause discomfort when you
wear shoes. Treat the corn by using a file or pumice stone to reduce its size after a warm bath, then apply emollients to keep the area softened and pliable. Use silicone or moleskin padding on top
of the area when wearing shoes. Do foot exercises. Theoretically, exercises like extending, then curling the toes, splaying the toes, and moving the toes individually may help prevent the digital
contracture that causes hammertoe. Try these suggestions and see what works best for you.
Surgery to straighten the toe may be needed if an ulcer has formed on either the end or the top surface of the toe. Surgery sometimes involves cutting the tendons that support movement in the toe so
that the toe can be straightened. Cutting the tendons, however, takes away the ability to bend the very end of the toe. Another type of surgery combines temporary insertion of a pin or rod into the
toe and alteration Hammer toes
or repair of the tendons, so that the toe is straightened.
After surgery, the deformity rarely recurs.
The American Podiatric Medical Association offers the following tips for preventing foot pain. Don't ignore foot pain, it's not normal. Inspect feet regularly. Wash feet regularly, especially between
the toes, and dry them completely. Trim toenails straight across, but not too short. Make sure shoes fit properly.