Hammer, claw, and mallet toes are toes that do not have the right shape. They may look odd or may hurt, or both. Tight shoes are the most common cause of these toe problems. A hammertoes
is a toe that bends down toward the floor at the middle toe joint. It usually
happens in the second toe. This causes the middle toe joint to rise up. Hammer toes often occur with bunions. Claw toe often happens in the four smaller toes at the same time. The toes bend up at the
joints where the toes and the foot meet. They bend down at both the middle joints and at the joints nearest the tip of the toes. This causes the toes to curl down toward the floor. A mallet toe often
happens to the second toe, but it may happen in the other toes as well. The toe bends down at the joint closest to the tip of the toe.
Footwear is actually the leading cause of this type of toe deformity so much so that people sometimes require hammer toe surgery to undo some of the damage. The most common problem is wearing shoes
that are too short, too narrow or too tight. These shoes constricts the feet and force the toes into a bend position. Women are more at risk especially due to high heels. Footwear isn?t the only
problem, poor foot posture can lead to muscle and even bone imbalances. This asymmetry can cause excessive strain on the toes either by forcing the toe into unnatural positions. Arthritis can also
play a factor in the development of hammer toe, especially if the toe joint is stiff and incapable of a full range of motion.
The symptoms of a hammer toe are usually first noticed when a corn develops on the top of the toe and becomes painful, usually when wearing tight shoes. There may hammertoe
be a bursa under the corn or instead of a corn, depending on the pressure. Most of the symptoms
are due to pressure from footwear on the toe. There may be a callus under the metatarsal head at the base of the toe. Initially a hammer toe is usually flexible, but when longstanding it becomes more
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
Prescription strength medicines to decrease pain and inflammation. Physical Therapy. To strengthen poorly functioning muscles and stretch tight muscles that may be exacerbating the toes. Special
ultrasound techniques may reduce inflammation. Custom Foot Orthotics. An orthotic with an exact mold of your foot to better align and support the foot to ease current discomfort and prevent future
progression. Toe Splints or Pads. Specific pads may prevent pressure and physical irritation in shoes. Toe splints and toe spacers physically realign the toes and can lessen pain and halt or stall
hammer toe progression. Cortisone injections are strong anti-inflammatory agents to decrease pain, and swelling directly at the toe region. Injections only treat the symptoms, and in some cases used
in caution (and sparingly) they can weaken supporting ligaments of the toe(s).
There are generally two methods surgeons use to correct hammer toes, they are joint resection (arthroplasty) or bone mending (fusion), and the location where this is performed on the toe depends on
where the toe is buckled. Its important to recognize that most of the surgical work involved the joints of the toe, not the joint of the ball of the foot. Sometimes a toe relocation procedure is
needed when the joint of the ball of the foot is malaligned (subluxed or dislocated).