The smallest four toes of each foot have three bony segments connected by two joints, just as the fingers do. hammertoe
is a deformity in which one or more of the small toes develops a bend at the joint between
the first and second segments so that the tip of the toe turns downward, making it looks like a hammer or claw. The second toe is affected most often.
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.
Common symptoms of hammertoes include pain or irritation of the affected toe when wearing shoes. corns and calluses (a buildup of skin) on the toe, between two toes, or on the ball of the foot. Corns
are caused by constant friction against the shoe. They may be soft or hard, depending upon their location. Inflammation, redness, or a burning sensation. Contracture of the toe. In more severe cases
of hammertoe, open sores may form.
Your healthcare provider will examine your foot, checking for redness, swelling, corns, and calluses. Your provider will also measure the flexibility of your toes and test how much feeling you have
in your toes. You may have blood tests to check for arthritis, diabetes, and infection.
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.
Probably the most frequent procedure performed is one called a Post or an Arthroplasty. In this case a small piece of bone is removed from the joint to straighten the toe. The toe is shortened
somewhat, but there is still motion within the toe post-operatively. In other cases, an Arthrodesis is performed. This involves fusing the abnormally-contracted joint. The Taylor procedure fuses only
the first joint in the toe, whereas the Lambrinudi procedure fuses both joints within the toe. Toes which have had these procedures are usually perfectly straight, but they take longer to heal and
don't bend afterwards. A Hibbs procedure is a transfer of the toe's long extensor tendon to the top of the metatarsal bone. The idea of this procedure is to remove the deforming cause of the
hammertoes (in this case, extensor substitution), but to preserve the tendon's function in dorsifexing the foot by reattaching it to the metatarsals. Fortunately, the Gotch (or Gotch and Kreuz)
procedure--the removal of the base of the toe where it attaches to the foot, is done less frequently than in years past. The problem with this procedure is that it doesn't address the problem at the
level of the deformity, and it causes the toe to become destabilized, often resulting in a toe that has contracted up and back onto the top of the foot. You can even have an Implant Arthroplasty
procedure, where a small, false joint is inserted into place. There are several other procedures, as well.
Be good to your feet, because they carry you. They are designed to last a lifetime, but that doesn?t mean they don?t need some love and care as well as some basic maintenance. Check your feet
regularly for problems. This is especially true if you have diabetes or any other medical condition that causes poor circulation or numbness in your toes. If you do, check your feet every day so
problems can be caught early on. Good circulation is essential. When you're sitting down, put your feet up. If you've been sitting for a while, stretch your legs Hammer toe
and feet. Give yourself a foot massage, or ask someone you love for a foot massage. A warm foot
bath is also a good idea.