A hammertoe is a deformity at the joints of the toe that causes the toe to take on a contracted or bent position. This bending causes the toe to take on a mallet or hammer appearance when viewed from the side. Any toe can be involved, but the condition usually affects the second through fifth toes, known as the lesser digits. Hammertoes are more common in females than they are in males. Often corns develop on the tops of the deformed joints. The symptoms associated with hammertoes can be relieved through conservative measures; however, surgery is the only way to reduce the deformity and return the shape of the toe to its normal position.
Visiting our office at the first sign of a contracture of a toe or irritation on the top of the toe is often a good idea. Treating hammertoes early with conservative measures will slow the progression of the deformity. Like many foot problems, hammertoes are a progressive problem, meaning they get worse with time and tend to not resolve on their own. Treatment ranges from very conservative options to surgical procedures, depending on the severity of the condition.
As mentioned previously, conservative care often involves treating the symptoms associated with hammertoes. This usually does not correct the underlying disorder. This includes the following:
Padding and Taping—Often padding and taping are the first steps in a treatment plan. Padding the bony prominence minimizes pain and allows the patient to continue a normal, active life. Taping may change the imbalance around the toes and thus relieve the stress and pain.
Shoe Gear Modification—Larger toe boxes and wider shoes can be used to accommodate the deformed toes. This will result in decreased pressure against the joints and relieve pain.
Medication—Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the joint deformity.
Custom-Molded Shoe Inserts—Custom-made shoe inserts made by your podiatrist may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the hammertoe deformity.
Often, conservative treatments are unsuccessful and surgical intervention is required to fix the underlying deformity. Hammertoes are progressive and often get worse with time. Fixing the deformities early on usually results in a quicker surgical recovery and better outcome.
For less severe deformities, removing the bony prominence and restoring normal alignment of the toe joint often resolves the pain. Severe hammertoes, which are not fully reducible, may require more complex surgical procedures, which may include fusion of the affected joint or elongating tendons.