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 A hammer toe is a toe that is contracted, or bent downward too much, at the PIP joint (middle joint in the toe) leading to severe pressure and pain. Ligaments and tendons that have tightened cause the toe’s joints to curl downward and remain in this position. Hammer toes may occur in any toe, except the big toe. There is often discomfort at the top part of the toe that is rubbing against the shoe. A hammer toe is a fairly common condition in societies that wear shoes, and this condition is worsened by ill-fitting shoes.
Although the toes may seem small and relatively insignificant, they are vital to walking, stability and balance. Hammertoes may seem to be a minor inconvenience, but if left untreated, they will become serious permanent deformities. In this unnatural position, the inside of the shoe rubs against the bent toe joint(s), gradually causing calluses or pressure ulcers to form, usually on the top of the affected toe(s). When deformities reach this stage, the toes are fixed in a bent position and cannot be easily straightened. For this reason, it is important to seek treatment for hammertoes when they first begin to develop, before they become fixed.
Treatment
Treatment of hammer toes depends on the severity of the deformity. If the deformity is not severe, simply changing to shoes that fit correctly may stop the formation of a hammer toe and return the
toe(s) to a more normal position. When the toe(s) first starts to buckle, they can be straightened easily. When choosing a shoe, it is important to make sure the toe area is high and broad, and can accommodate the hammer
toe(s) to prevent friction rubbing of the toe(s). If the hammer toe is caused by flat feet, a podiatrist can fit the patient for custom-molded orthotics to provide a better arch for the foot and help the foot and toe muscles work together. Other conservative treatments include the use of products which are designed to relieve hammer toes, such as hammer toe crests and hammer toe splints. These devices will help hold down the hammer
toe(s). Gel toe shields, toe caps, and pads placed over the calluses will relieve the pressure.
If the deformity is more advanced, the toes will not completely straighten out on their own and a contracture exists, surgery may be suggested to correct the position of the
toe(s). Arthroplasty is a minor surgical procedure designed to lengthen a toe muscle that has shortened over time due to the hammer toe deformity. This usually permits enough movement for the toe to straighten. It is important to seek early treatment from your podiatric physician for hammer toes.
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