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Hammer Toes

Introduction

This is Patient Education Article – Hammertoes. It explains the basics of the pathology including signs, symptoms and basic treatment options.

Hammertoes are the most common deformity of the lesser toes and usually affect women more than men. The most commonly affected toe is the 2nd toe.

What is a Hammer Toe?

A hammertoe is a deformity of the lesser toes characterized by curling downward of the distal joints of the toes and contracture and pulling up of the joints at the base of the toes.

What Causes Hammer Toes?

Hammertoes are usually caused by an imbalance of tissues (tendons and ligaments) around the toe, particularly the tendon on the top of the toe called the extensor digitorum longus.

Symptoms

The symptoms of hammertoes usually include pain on the top of the toe(s) or at the tip of the toes. Calluses or corns can form where the toes rub on shoes or the ground causing redness or inflammation. Sometimes the toes can develop ulcerations or infections, especially in patients with diabetes or neuropathy. This can lead to deep infections if not cared for promptly.

Diagnosis

The diagnosis of hammertoes is readily apparent on clinical exam, however, to fully evaluate your condition, Dr. DeMill will take x-rays to determine the degree of the deformity and to assess the possible causes and changes that have occurred.

Sometimes hammertoes are associated with instability of the toe joints at the ball of the foot. An MRI may be ordered to evaluate for ligament tearing or attenuation.

Non-Surgical Treatment

Initial treatment for hammertoes is aimed at alleviating the pain that occurs with the deformities, but will not reverse the deformity itself. These treatments include:

  • Changes in shoe wear.Wearing the right kind of shoes is very important. Choose shoes that have a wide toe box and forgo those with pointed toes or high heels, which may aggravate the condition.
  • Padding. Gel sleeves, cushions or padding can be placed over the hammertoes to help
    minimize irritation in shoe wear. You can get find these at medical supply stores, online retailers or even some shoe stores.
  • Activity modifications. Avoid activity that causes pain, including standing for long periods of time.
  • Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help to relieve pain. These medications are available in oral or topical form.
  • Icing. Applying an ice pack several times a day may help reduce inflammation and pain.

Surgical Treatment

When the pain of hammertoes interferes with daily activities, it’s time to discuss surgical options. You and Dr. DeMill will discuss the option and together you can decide if surgery is best for you.

A variety of surgical procedures are performed to treat hammertoes. The procedures are designed to straighten the toes and correct the soft tissue and bony changes. The toes are either temporarily pinned or fixed with a permanent implant to keep the toes straight. The goal of these corrections is the elimination of pain. In selecting the procedure or combination of procedures for your specific case, Dr. DeMill will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

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