The name Hammer toe
comes from the way the tip of the toe hits or hammers on the floor with each step. The primary deformity seen in a
hammer toe is found at the PIPJ (proximal interphalangeal joint) which is the first or more proximal of the two joints of the toe. A mallet toe, on the other hand, is a similar deformity but is found
in the DIPJ (distal interphalangeal joint). And lastly, claw toes are a deformity where the entire toe grabs and involves the MPJ (metatarsal phalangeal joint) PIPJ and DIPJ. Collectively, these
deformities are referred to as hammer toes. Hammer toes can affect one or all of the toes simultaneously.
Hammer toes are most frequently caused by a muscle - tendon imbalance in the foot, and are seen both in adults and children. Foot muscles work in pairs to straighten and bend the toes. If your foot
has a biomechanical defect, the muscles tighten and the tendons shorten. Eventually, the toe muscles can?t straighten the toe, even when barefoot. Contributing factors are poor choices in footwear,
arthritis, or trauma.
A toe (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.
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
The treatment options vary with the type and severity of each hammertoe, although identifying the deformity early in its development is important to avoid surgery. Podiatric medical attention should
be sought at the first indication of pain and discomfort because, if left untreated, hammertoes tend to become rigid, making a nonsurgical treatment less of an option. Your podiatric physician will
examine and X-ray the affected area and recommend a treatment plan specific to your condition.
Toes can be surgically realigned and made straight again. They can even Hammer toe
be made shorter. The good
news is that toes can be corrected. Hammer toe surgery is often synonymous with ?toe shortening?, ?toe job? and/or ?toe augmentation?. Depending on the severity and length of the toe, there are
several methods to surgically correct a hammer toe. In general, the surgery involves removing a portion of the bone at the contracted joint, to realign the toe.