is a painful deformity wherein a toe bends unnaturally
and becomes clawlike. This happens because the tendons of the toe contract abnormally, forcing the toe to bend downward and the middle joint of the toe to protrude upward. Although any toe may be
affected, hammertoe usually affects the second toe. The toe assumes a clawlike position and cannot be straightened out. When someone with hammertoe wears shoes, the toe is constantly rubbed, so
walking may become especially painful if a callus on the sole of the foot or a corn on the top of a toe develops.
A common cause of hammer toe is wearing shoes that do not fit properly. Poorly-fitting shoes can hold the toes in an abnormal position and result in tightening of the muscles required to maintain
that position. In particular, shoes that have high heels and are narrow at front tend to push the toes into an abnormal, bent position. Less commonly, diseases of the nerves, muscles, or joints (such
as arthritis) can result in the hammer toe deformity.
A soft corn, or heloma molle, may exist in the web space between toes. This is more commonly caused by an exostosis, which is basically an extra growth of bone possibly due to your foot structure. As
this outgrowth of excessive bone rubs against other toes, there is friction between the toes and a corn forms for your protection.
First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a
metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in
the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.
Non Surgical Treatment
Treatment options for a hammertoe are based on the severity of the condition. A hammertoe caused by inappropriate footwear can be corrected by wearing properly fitting shoes. If a high arch caused
the condition, wearing toe pads or insoles in your shoes can help. These pads work by shifting your toe?s position, which relieves pain and corrects the appearance of your toe.
For the surgical correction of a rigid hammertoe, the surgical procedure consists of removing the damaged skin where the corn is located. Then a small section of bone is removed at the level of the
rigid joint. The sutures remain in place for approximately ten days. During this period of time it is important to keep the area dry. Most surgeons prefer to leave the bandage in place until the
patient's follow-up visit, so there is no need for the patient to change the bandages at home. The Hammer toe
patient is returned to a stiff-soled walking shoe in about two
weeks. It is important to try and stay off the foot as much as possible during this time. Excessive swelling of the toe is the most common patient complaint. In severe cases of hammertoe deformity a
pin may be required to hold the toe in place and the surgeon may elect to fuse the bones in the toe. This requires several weeks of recovery.
How can I prevent hammer toe? Avoid wearing shoes that are narrow or don?t fit well. Also, don?t wear heels higher than 2 inches. Instead, choose shoes with a wide toe box that give you ? inch
between the end of your longest toe and the inside tip of the shoe. Check often to make sure your child?s shoes fit, especially when he or she is having a growth spurt.