Essentially, there's one consistent type of Hammer toes
, the condition
in which your toes are contracted into a hammer or upside-down "V" shape. However, depending on its severity, hammertoe is characterized into two forms. Flexible hammertoe is hammertoe in which the
joints of the toes are still moveable or flexible and can be treated with nonsurgical therapies. Rigid hammertoe is the more serious condition in which the joints' muscles and tendons have lost any
flexibility and the contraction cannot be corrected by nonsurgical means. As a result, surgery is generally required to deal with the problem. This is why it's important to consult a physician as
soon as the problem is recognized for the possibility of successful nonsurgical treatment.
Your shoes, your genetic predisposition, an underlying medical condition or all of these can make you susceptible to developing one of these deformities of the toes. The genes your parents gave you.
When it comes to genetics, the foot type you?re born with predisposes you to developing this type of joint deformity over a lifetime. For many, a flat flexible foot leads to hammertoes as the foot
tries to stabilize against a flattening arch. Those with high arches can also form Hammer
hammertoes as the extensor tendons overpower the flexors.
Hammer toes can cause problems with walking and lead to other foot problems, such as blisters, calluses, and sores. Pain is caused by constant friction over the top of the toe?s main joint. It may be
difficult to fit into some shoe gear due to the extra space required for the deformed toe. In many cases there will be pain on the ball of the foot over the metatarsals along with callus formation.
This is due to the toes not functioning properly, failing to properly touch the ground during the gait cycle. The ball of the foot then takes the brunt of the ground forces, which causes chronic
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
Many people start by treating the problem themselves when they have a painful corn or callus. They try to remove the corn by cutting it off or by applying strong acids, and they try to cushion the
toe by applying cushioned pads. Because these treatments can be difficult to perform by oneself (and should never be done by oneself when the patient is diabetic or circulation is poor), and because
these treatments only treat the symptom, not the structural deformity that causes their symptom, these treatments can often provide only limited success, and often any success is for only short
periods of time. Changes in shoe choices and various types of paddings and other appliances may help, too. For longer-lasting help, we must examine the cause of the deformity. The reason for knowing
the cause is that the type of treatment will vary, depending upon the cause of the complaint. Orthotics help control the causes of certain types of contracted toes, (those caused by flexor
stabilization, for example), but not other types.
The technique the surgeon applies during the surgery depends on how much flexibility the person's affected toes still retain. If some flexibility has still been preserved in their affected toes, the
hammer toes might be corrected through making a small incision into the toe so the surgeon can manipulate the tendon that is forcing the person's toes into a curved position. If, however, the
person's toes have become completely rigid, the surgeon might have to do more than re-aligning the person's tendons. Some pieces of bone may have to be removed so the person's toe has the ability to
straighten out. If this is the case, some pins are attached onto the person's foot afterwards to fix their bones into place while the injured tissue heals.
Daily modifications and correct shoe choices can prevent and slow the progression of hammertoe deformities. The main cause in hammertoe deformities is muscle/tendon dysfunction. Wearing of
ill-fitting, tight, high heeled shoes contributes to the progression to hammertoe deformities. Also, bunion conditions can enhance the formation of hammertoes. A key to prevention of hammertoes is
the wearing of correct footwear, specifically shoes with appropriate support and a deep, wide toe box.