Hammer toe deformities can be painful and unsightly. These toe deformities can be the result of a muscle/tendon imbalance or often the end stage result of some systemic disease such as diabetes or arthritis, especially Rheumatoid arthritis. Hammertoe deformities are progressive and can be prevented.
Shoes that narrow toward the toe force the smaller toes into a bent upward position. This makes the toes rub against the inside of the shoe, and creates corns and calluses, aggravating the toes further. If the shoes have a high heel, the feet are forced forward and down, squeezing the toes against the front of the shoe, which increases the pressure on the toes and makes them bend further. Eventually, the toe muscles become unable to straighten the toe.
The symptoms of a hammer toe include the following. Pain at the top of the bent toe upon pressure from footwear. Formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe.
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
To keep your hammertoes more comfortable, start by replacing your tight, narrow, pointy shoes with those that have plenty of room in the toes. Skip the high heels in favor of low-heeled shoes to take the pressure off your toes. You should have at least one-half inch between your longest toe and the tip Hammer toe of your shoe. If you don't want to go out and buy new shoes, see if your local shoe repair shop can stretch your shoes to make the toe area more accommodating to your hammertoe.
The deformity is corrected in a variety of ways. There are actually a large number of procedures. The simplest procedure would involve a Tenotomy, the cutting of the tendon causing the deformity or a Tendon Lengthening procedure. These procedures are infrequently done, though, as the structural deformity (the arthritis and joint adaptation) is not addressed with these surgeries. Other soft-tissue procedures involve rebalancing the tendons around the joint. There are several techniques to do this, but the most common is probably the Girdlestone-Taylor procedure, which involves rerouting the tendons on the bottom of the toe up and over the toe where it sticks up, so that the tendon helps pull the toe downwards into proper alignment.