What are hammertoes, mallet toes and claw toes? Often the words are used interchangeably to mean an abnormally contracted toe like the drawing above. Technically speaking, a "Hammer toes" is the name for a toe that is contracted at the first toe joint. If it's contracted at the second toe joint it is called a "mallet toe". IIf a toe is contracted at both toe joints, it is called a "claw toe". Each of these conditions can be quite uncomfortable and are cosmetically unappealing.
Hammer toe most frequently results from wearing poorly fitting shoes that can force the toe into a bent position, such as excessively high heels or shoes that are too short or narrow for the foot. Having the toes bent for long periods of time can cause the muscles in them to shorten, resulting in the hammer toe deformity. This is often found in conjunction with bunions or other foot problem (e.g., a bunion can force the big toe to turn inward and push the other toes). It can also be caused by muscle, nerve, or joint damage resulting from conditions such as osteoarthritis, rheumatoid arthritis, stroke, Charcot-Marie-Tooth disease, complex regional pain syndrome or diabetes. Hammer toe can also be found in Friedreich's ataxia.
The most obvious symptoms of this injury will be the the middle toe joint is permanently bent at an angle. In the beginning movement may still be possible but as time passes and the injury worsens the toe will be locked in place and possible require hammer toe correction surgery to fix. Another key indicator of hammer toe is that a lump or corn will form on top of the toe. The toe joint will be painful and walking can cause severe discomfort. Occasionally a Hammer toes callus may form on the sole of the injured foot. If you see any of these symptoms together or have been enduring pain for some time, seeing a podiatrist should be your next step.
Your healthcare provider will examine your foot, checking for redness, swelling, corns, and calluses. Your provider will also measure the flexibility of your toes and test how much feeling you have in your toes. You may have blood tests to check for arthritis, diabetes, and infection.
Non Surgical Treatment
Early on, when a hammertoe first starts and is still flexible, here are some ways it might be treated. Your healthcare provider may splint or tape the toe into the correct, normal position. You can use your fingers to stretch your toes and toe joints toward a more normal position. Exercise your toes by trying to pick up marbles with them or by wadding up a towel on the floor with your toes. Padding may be used to change where your weight falls when you walk on the foot.
Hammertoe surgery is performed when conservative measures have been exhausted and pain or deformity still persists. The surgery is performed on an outpatient basis. It typically required about one hour of time. An incision is placed over the inter-phalangeal joint. Once the bone is exposed, the end portion of the bone is removed. Your surgeon may then use pins or other fixation devices to assist in straightening the toe. These devices may be removed at a later date if necessary. Recovery for hammertoe surgery is approximately 10 to 14 days. You are able to walk immediately following the surgery in a surgical shoe. Swelling may be present but is managed as needed. Physical therapy is used to help reduce swelling in the toe or toes after surgery. Most of these toe surgeries can be performed in the office or the outpatient surgery under local anesthesia.
As long as hammertoe causes no pain or any change in your walking or running gait, it isn?t harmful and doesn't require treatment. The key to prevention is to wear shoes that fit you properly and provide plenty of room for your toes.