This deformity gets its name from the fact that the toe resembles a hammer when this affliction is present. Hammertoes occur on the middle joints of the lesser toes, causing an abnormal bend.

They are usually the result of either a muscle or a ligament imbalance that puts excessive pressure on the tendons and joints of the toe.

If left alone, hammertoes always worsen, and usually cause significant pain, especially when wearing closed shoes, which force the bent toe to rub against the the top part of the shoe. In addition, this constant friction often results in the development of an unwanted corn.

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What Exactly Causes Hammertoes?

There are four causes of the muscular imbalance that often leads to the development of hammertoes. Not necessarily in order of importance, they are: genetics, ill fitting shoes, disease and trauma. More on each follows below.

Genes

As is the case with many medical conditions, predisposition can be a factor in hammertoe development. The foot type you are born with can make you more susceptible to this condition, especially if they are flat and flexible. This is because a flattening arch often occurs as a foot tries to stabilize itself.

High arches are also problematic because extensor tendons, which are those muscles that attach to both the big and lesser toes, overpower the flexors, which are the tendons that serve to bend them.

Ill-Fitting Shoes

If shoes are too narrow or put too much pressure on the toes, such as high heels, or if they provide little or no arch support, hammertoes can easily occur.

They occur more frequently in women because of high heels, which may greatly accentuate the beauty of a woman’s leg, but must have secretly been designed by someone who did not wish women well at all.

Disease

Some neuromuscular maladies can contribute to the formation of a hammer toe. Arthritis in a toe joint can easily lead to the formation of this malady, and diabetics face the possible danger of the loss of a toe or foot due to complications arising from an infected corn or lesion of any kind.

Trauma

It is not common, but traumatic injury can result in a hammertoe.

Some Recognizable Symptoms of Hammertoe

While symptoms will understandably vary from patient to patient, there are certain symptoms that are almost always present in one degree or another in all hammertoes. These include:

  • A joint in the toe that is slowly becoming more and more rigid
  • Pain at the top of the toe that is bent as well as in the ball of the foot
  • The formation of corns and callouses at the top of the toe joint
  • Inflammation or a burning sensation on the affected joint
  • Pain whenever the toe joint moves
  • Swelling that appears at the joint
  • Although rare, open sores can also be symptoms of this deformity.

Hammertoe Prevention Tips

You can reduce the risks of contracting a hammertoe by considering the following precautions. One, wear sensible shoes always.

Even if you are headed for some formal affair, avoid high heeled or any footwear that exerts excessive pressure on the toes. Also pick shoes with a good arch support.

Secondly, if a corn or callous appears, use a pumice stone regularly after a warm bath to help reduce its size. Keep the area pliable and soft by generously using lotions, and apply silicone or moleskin padding to protect the area while wearing shoes.

Last but not least, do the foot exercises to keep toe muscles strong and pliant.

Hammertoe Diagnosis and Treatment

We can easily diagnose a hammertoe, but will always conduct a physical examination, which includes touching and moving your foot in order to see joint reactions. X rays may be in order as well, just to be on the safe side.

Non surgical methods may be recommended  at first, but if conservative treatments such as: applying a non medicated hammertoe pad, wearing shoes with a deep toe box, using an ice pack to relieve swelling and loose fitting shoes do not relieve pain and continue to disrupt every daily activities, surgery will be the most suitable solution.

Hammertoe Surgery, Risks and Recovery

Hammertoe surgery should not be an impulsive decision. It is only recommended if pain is severe, a patient cannot perform daily activities or if conservative, non surgical treatments have failed to provide any relief.

Surgery is usually performed on the middle joint of the toe. The most common procedure is Proximal Interphalangeal, which is also known as PIP joint fusion.

This process involves straightening and stabilizing the toe by permanently fusing the two bones in the affected joint.

Traditionally, this is accomplished by cutting the ends of the bones and then fusing them together. A stainless steel K-wire is inserted, which is a pin that will hold the bone ends in place for three to six weeks, after which time it is removed.

Two other surgical possibilities include: Tendon Transfer, which concerns straightening the toe by rerouting tendons from the bottom of the toe to the top and Joint Resection, a procedure in which the end of the bone at the fixed joint is removed and the toe is kept in a straight position.

Hammertoe surgery is an outpatient procedure and no hospital stay is required. You will walk in and out of the facility on the same day and will leave with a bandage on your foot that the surgeon will remove along with the stitches in his or her office some two to four weeks later.

Some stiffness, swelling and redness may occur, and that can last for four to six weeks. It is prudent during recovery time that you give your toes time to heal by staying off them and keeping them elevated as much as possible.

It should be noted that the following potential complications are very uncommon and unlikely to occur with proper post operative care.

Some of the risks associated with hammertoe surgery, however, can include: infection, neuritis, painful or unsightly scarring, chronic swelling, poor or non fusion of bone, and recurrence of deformity, which statistically has been known to occur in 5 to 10% of hammertoe surgery participants. (Reappearance is not always on the same toe or the same joint.)

If you live in anywhere throughout Florida, the United States or beyond, the place to go for any type of foot or ankle care is JAWS Podiatry! Situated in Hollywood, Florida, we are dedicated to healing, resolving foot pain and improving the quality of life for all of our patients. Schedule a consultation today!

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It is not self evident that all feet and all foot surgeons are created equally. The cosmetic and functional procedures we perform require mastery over an extensive set of skills that take years to develop. 

So when you need to keep your best foot forward, make sure that it goes in that direction only and contact our caring, experienced and thoroughly prepared staff at Jaws Podiatry.

Final thought about feet: The human foot  is a masterpiece of engineering and a work of art- Leonardo Da Vinci

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