A Hammer toe
or contracted toe is a deformity of the proximal interphalangeal joint of the second, third, or
fourth toe causing it to be permanently bent, resembling a hammer. Mallet toe is hammertoes
a similar condition
affecting the distal interphalangeal joint.
Hammertoes are a contracture of the toes as a result of a muscle imbalance between the tendons on the top of the toes (extensor tendons) and the tendons on the bottom of the toes (flexor tendons). If
there is an imbalance in the foot muscles that stabilize the toe, the smaller muscles can be overpowered by the larger flexor and extensor muscles.
The most obvious symptom of hammertoe is the bent, hammer-like or claw-like appearance of one or more of your toes. Typically, the proximal joint of a toe will be bending upward and the distal joint
will be bending downward. In some cases, both joints may bend downward, causing the toes to curl under the foot. In the variation of mallet toe, only the distal joint bends downward. Other symptoms
may include Pain and stiffness during movement of the toe, Painful corns on the tops of the toe or toes from rubbing against the top of the shoe's toe box, Painful calluses on the bottoms of the toe
or toes, Pain on the bottom of the ball of the foot, Redness and swelling at the joints. If you have any of these symptoms, especially the hammer shape, pain or stiffness in a toe or toes, you should
consider consulting your physician. Even if you're not significantly bothered by some of these symptoms, the severity of a hammertoe can become worse over time and should be treated as soon as
possible. Up to a point hammertoes can be treated without surgery and should be taken care of before they pass that point. After that, surgery may be the only solution.
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination,
the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the
degree of the deformities and assess any changes that may have occurred.
Non Surgical Treatment
Treating hammertoe involves straightening the toe, making tendons in the toes flexible again, and preventing the problem from returning. Some simple treatments include splinting the toe to keep it
straight and to stretch the tendons of the foot. Using over-the-counter pads, cushions or straps to decrease discomfort Exercising the toes to relax the foot tendons (a session with a physical
therapist may help you get started with foot exercises) Wearing shoes that fit properly and allow toes plenty of room to stretch out.
A variety of anaesthetic techniques are possible. Be sure an discuss this with your surgeon during your pre-op assessment. The type of surgery performed will depend on the problem with your toes and
may involve releasing or lengthening tendons, putting joints back into place, straightening a toe and changing the shape of a bone.Your surgeon may fix the toes in place with wires or tiny screws.