Definition & Overview
Hammertoe is a condition characterized by a deformity of the joint that is closest to the toenail. These joints are normally flexible, but when a person has a hammertoe, the joints become rigid as the condition progresses, causing them to remain in a bent position.
There are two types of hammertoes: flexible and fixed. If the toes can still be straightened, the condition is described as a flexible hammertoe. Otherwise, it is referred to as a fixed hammertoe. A flexible hammertoe can be treated through non-surgical methods while the latter requires surgery.
Cause of Condition
Hammertoes are usually caused by the prolonged use of improper fitting footwear or shoes that are too small, causing the toes to bend. If they remain in this position for a long time, it creates an imbalance between the muscles and ligaments, causing them to become stiff. The joints lose their flexibility and the toes remain in a bent position.
High-heeled shoes can also cause hammertoes because the pressure is transferred to the toes causing them to bend for extended periods. A person with hammertoes who continue wearing these types of shoes will risk irritating the skin above the joints. It is possible for corns and blisters to form, which can easily aggravate the condition.
Hammertoes are usually very painful, especially when trying to flex the joints. If the condition is left untreated, the continuous rubbing of the toes against the shoes will result in skin irritation that does not only add more pain but can also become infected over time.
Hammertoes need to be treated while in the early stages to ensure that the joints can still retain at least some degree of flexibility.
Who To See & Types of Treatment Available
Hammertoe is a painful condition, which will only get worse over time if left untreated. If you’re having problems with your feet, you should consult your doctor or a general practitioner. After performing a physical examination and checking your medical history, the doctor will decide if treatment can be provided or if you will need to consult an orthopedist (specialist in bones).
If the condition is still in its early stages, medical treatment may not be required at all as a simple change in footwear could improve the condition. Doctors recommend wearing shoes that provide enough space for the toes to move properly. Providing at least a half-inch from the tip of the longest toe should be comfortable enough. Using shoe pads or cushions can also offer added comfort.
In addition to changing shoes, toe exercises will also help to strengthen the muscles. Some common exercises are to pick things up from the floor using the toes or contracting and extending them on a regular basis.
If you still experience pain after changing your shoes and if your toes feel numb, it could be a sign that blood isn’t circulating properly. In such cases, medical attention should be sought immediately.
If all other non-surgical procedures have failed to treat the condition and alleviate the pain, surgery should be considered.
Flexible hammertoes can be treated via a tendon transfer surgery. This procedure involves surgically rerouting tendons in the toe to straighten the joint. In cases of fixed hammertoe, more complex surgical procedures are required. One such procedure is a joint resection. This involves making an incision above the affected toes and cutting the tendons and ligaments. A surgeon will then remove a portion of the bone and replace it with pins to straighten the toes. The pins can be removed after a few weeks. Another procedure called fusion involves cutting the ligaments, tendons and tip of the bones. The tips will then be connected using pins or other implants to keep the toes straight while the bones heal.
It can take anywhere between a few weeks to several months to recover from a surgical procedure. During this time, the patient is instructed to avoid placing pressure on the affected foot, which means using crutches when moving from one location to another and getting enough rest to hasten the healing process.
Hammertoe surgery may not be recommended for some people, especially those with other medical conditions. Make sure that you inform the doctor or orthopedic surgeon of other medical conditions because they may result in complications, such as bleeding, formation of blood clots, and infections.
- American Orthopaedic Foot & Ankle Society
- American Academy of Orthopaedic Surgeons