Hammer toes is a Z-shaped deformity caused by dorsal subluxation at the metatarsophalangeal joint. Diagnosis is clinical. Treatment is modification of footwear and/or orthotics. The usual cause is misalignment of the joint surfaces due to a genetic predisposition toward aberrant foot biomechanics and tendon contractures. RA and neurologic disorders such as Charcot-Marie-Tooth disease are other causes.
The APMA says that hammertoe can result from a muscle imbalance in the foot that puts undue pressure on the joints, ultimately causing deformity. Inherited factors can contribute to the likelihood of developing hammertoe. Arthritis, stroke or nerve damage from diabetes or toe injuries such as jamming or breaking a toe can affect muscle balance in the foot, leading to hammertoe. The Mayo Clinic says that wearing improper shoes often causes hammertoe. Shoes that squeeze the toes, such as those with a tight toe box or with heels higher than two inches, can put too much pressure on the toe joints.
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
If the problem is caught in the early stages you can avoid hammer toe surgery. One of the easiest methods of treatment is to manipulate the toe out of hammertoes a bent position then splint and buddy wrap it alongside it?s larger neighbour. This method of hammer toe taping will help the problem to fix itself. Make sure the toe isn?t resuming its bent shape during the recovery. To alleviate some of the painful symptoms of hammer toe avoid wearing high heels or shoes that cramp or stifle your feet. Choosing a pair of minimalist shoes can be an excellent choice for both foot and postural health. Wearing shoes that give the toes plenty of space and are comfortable lined is also a smart choice. Hammer toe recovery starts be treating the toe respectfully. Soft insoles or protection for the corn can also provide additional assistance.
If conservative measures fail to provide relief, or if your hammertoe is in advanced stages with rigidity and a significant amount of pain, surgery may be required. Some patients also require surgery if they have open sores or wounds related to their hammertoe. For patients who also suffer from bunions, a combined procedure may be appropriate, addressing both conditions within the same surgery. Recovery time will vary from patient to patient, depending on the extent of the surgical repair and other conditions that may also be present.