is caused when the middle joint (PIP) bends down towards the floor (flexion). To compensate, the
joints above and below (MTP, DIP) bend up (hyperextend). The result is that the middle part of the toe lifts up. Hammertoe is the most common deformity of the lesser toes (i.e. not the big toe). It
tends to only affect one toe, most commonly the second.
People who have a high-arched feet have an increased chance of hammer toes occurring. Also, patients with bunion deformities notice the second toe elevating and becoming hammered to make room for the
big toe that is moving toward it. Some patients damage the ligament that holds the toe in place at the bottom of the joint that connects the toe and foot. When this ligament (plantar plate) is
disrupted or torn, the toe floats hammertoe
at this joint. Hammer toes also occur in women wearing ill-fitting shoes or high heels, and children wearing shoes they have outgrown.
Symptoms of a hammertoe are usually first noticed as a corn on the top of the toe or at the tip which produces pain with walking or wearing tight shoes. Most people feel a corn is due to a skin
problem on their toes, which in fact, it is protecting the underlying bone deformity. A corn on the toe is sometimes referred to as a heloma dura or heloma durum, meaning hard corn. This is most
common at the level of the affected joint due to continuous friction of the deformity against your shoes.
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
Mild hammer toe in children can be treated by manipulating and splinting the affected toe. The following changes in footwear may help relieve symptoms. Wear the right size shoes or shoes with wide
toe boxes for comfort, and to avoid making hammer toe worse. Avoid high heels as much as possible. Wear soft insoles to relieve pressure on the toe. Protect the joint that is sticking out with corn
pads or felt pads. A foot doctor can make foot devices called hammer toe regulators or straighteners for you, or you can buy them at the store. Exercises may be helpful. You can try gentle stretching
exercises if the toe is not already in a fixed position. PIcking up a towel with your toes can help stretch and straighten the small muscles in the foot.
If these non-invasive treatments don?t work, or if the joint is rigid, a doctor?s only recourse may be to perform surgery. During the surgery, the doctor makes an incision and cuts the tendon to
release it or moves the tendon away from or around the joint. Sometimes part of the joint needs to be removed or the joint needs to be fused. Each surgery is different in terms of what is needed to
treat the hammertoe. Normally after any foot surgery, patients use a surgical shoe for four to six weeks, but often the recovery from hammertoe surgery is more rapid than that. An unfortunate reality
is that hammertoe can actually return even after surgery if a patient continues to make choices that will aggravate the situation. Though doctors usually explain pretty clearly what needs to be done
to avoid this.