What is Hammer Toe
A Hammer Toe deformity refers to an abnormal position of the toe, where one or more small toes buckle or bend-under, out of their normal position. A contracture of the toe occurs at the middle toe joint causing the toe to bend out of its normal straight position.
As the toe curls or bends-under certain soft tissue structures such as the tendons to the digits and the joint capsules may tighten and shorten over time. The shortening of the tendon will result in the toe contracture to worsen. The small toes consist of 3 bones and they articulate with 3 different joints. The toe becomes contracted at the middle joint of the toe leading to a very prominent bone on the top of the toe.
There are many causes of Hammer Toe. Some of them are congenital (a condition present at birth), hereditary, muscle imbalance around a toe, shoe gear and certain forms of arthritis.
Skin irritation (inflammed skin areas) or even corns (an accumulation of hard dead skin cells) may form on top of these prominent, contracted joints where shoes are likely to rub. In severe cases, a painful, swollen bursitis may develop on the top of the toe due to the constant irritation. This usually will lead to pain and inability to wear most types of shoes comfortably.
There are many conservative treatment options for hammer toes such as:
- Proper Foot Care. Daily removal and shaving down of the painful corns and lesions will help alleviate many symptoms from the hammer toe deformity.
- Padding and Strapping. Dispersion pads that can be placed on the top of the toes will help in preventing the toes from rubbing in the shoes. If the irritation to the top of the shoes is removed then the symptoms will start to resolve.
- Shoe Gear. Altering shoe styles will help in preventing irritation of the hammer toes. If the toes don’t rub on the top of the shoes then the painful corns will not develop.
- Injections. If a very irritated, painful bursitis develops on the top of the toe, then an injection of cortisone will help resolve the bursitis.
If all conservative methods fail then surgical management of the hammer toe may be necessary. Surgery entails a minor in office surgical procedure. The procedure can be performed under local anesthesia where only the affected toe is numbed. In order to straighten the toe, a portion of bone must be removed from the toe. You can return home the same day as the procedure and you can walk on the foot the same day as the surgery. Return to normal shoe gear may occur approximately 2-3 weeks.
A complete evaluation of the Hammer Toe deformity including x-rays of the foot are required in deciding which type of procedure has to be done in order to correct the Hammer Toe and prevent recurrence of the deformity.