A Hammer toe
is a deformity of the middle joint of a toe, producing a clenched, clawlike
appearance in the affected digit. The tendons in the toe become abnormally contracted, causing the toe to bend downward, which, in turn, forces the joint to protrude upward. A mallet toe is a
deformity in which the end joint of a toe becomes bent downward, so that the toe curls underneath itself. In either case the affected joints are stiff, and often the toe cannot be straightened out.
Constant rubbing against shoes may furthermore cause a painful corn (a round patch of rough, thickened, calloused skin) to develop over the joint or at the tip of the affected toe. Hammer and mallet
toes may occur in any toe, although the second toe is the most common site. These deformities are often painful and limit the toe?s range of motion-sometimes requiring surgery.
Essentially, hammertoes are caused by an abnormal interworking of the bones, muscles, ligaments and tendons that comprise your feet. When muscles fail to work in a balanced manner, the toe joints can
bend to form the hammertoe shape. If they remain in this position for an extended period, the muscles and tendons supporting them tighten and remain in that position. A common factor in development
of hammertoe is wearing shoes that squeeze the toes or high heels that jam the toes into the front of the shoe. Most likely due to these factors, hammertoe occurs much more frequently in women than
Hammer, claw, and mallet toes can cause discomfort and pain and may make it hard to walk. Shoes may rub on your toes, causing pain, blisters, calluses or corns, or sores. Sores can become infected
and lead to cellulitis or osteomyelitis, especially if you have diabetes or peripheral arterial disease. If you have one of these health problems hammertoes
and sores develop, contact your doctor.
Hammer toes may be easily detected through observation. The malformation of the person's toes begin as mild distortions, yet may worsen over time - especially if the factors causing the hammer toes
are not eased or removed. If the condition is paid attention to early enough, the person's toes may not be permanently damaged and may be treated without having to receive surgical intervention. If
the person's toes remain untreated for too long, however the muscles within the toes might stiffen even more and will require invasive procedures to correct the deformity.
Non Surgical Treatment
Conservative treatment is limited to accommodation, not correction, of the deformity, though some patients find the relief they can get from these options to be more than enough to put off or even
avoid surgery. These include better Footwear. Shoe gear with a wider toe box and higher volume causes less friction to the toes. Toe Braces and Strapping. Some toe braces and strapping techniques
take some pressure off the toes during gait. Custom molded orthotics can redistribute the forces through the tendons that control the toe, lessening the pain and extent of the deformity.The calluses
on the toe and the ball of the foot can be shaved occasionally to reduce some pain and pressure, although they will return due to the constant deformity.
Sometimes when the joints are removed the two bones become one as they are fused in a straightened position. Many times one toe will be longer than another and a piece of bone is removed to bring the
toes in a more normal length in relation to each other. Sometimes tendons will be lengthened, or soft tissue around the joints will be cut or rebalanced to fix the deformity. Angular corrections may
also be needed. The surgeon may place fixation in your foot as it heals which may include a pin, or wires.
How can I prevent hammer toe? Avoid wearing shoes that are narrow or don?t fit well. Also, don?t wear heels higher than 2 inches. Instead, choose shoes with a wide toe box that give you ? inch
between the end of your longest toe and the inside tip of the shoe. Check often to make sure your child?s shoes fit, especially when he or she is having a growth spurt.