Hammer toe

What is Hammer Toe?

In general,ahammer toe is a flexion (bending) contracture of one or both joints of the second through fifth toes. It is a deformity of the proximal interphalangeal joint (PIPJ) of the toe causing it to be permanently bent and resemble a hammer. The contracture of the toes can be flexible (reducible) at first and can get rigid (non-reducible) as the deformity progresses.

If there is flexion deformity of the distal phalangeal joint (DIPJ) of the toe only, then it is called a Mallet toe (resembling a mallet).

If there is a flexion deformity at the proximal interphalangeal joint (PIPJ) and distal interphalangeal joint (DIPJ), then the deformity is called a Claw toe (resembling a claw).

Hammertoes are progressive and will get worst if not treated or managed appropriately.

Causes of Hammer toe:

There are many causes for the contracture of the toes. Some may be intrinsic, due to the anatomy of the foot and other causes may be extrinsic, due to shoe gear.

  • High arched foot (pes cavus)
  • Low arched foot (pes planus)
  • Tight shoe gear or high heeled shoes.
  • Imbalance of the muscles within the foot.
  • Traumatic injury to the toe
  • May also be inherited

Symptoms of Hammer Toe:

  • Rubbing of the tip or top of the toes against the shoe and leading to pain.
  • Corns and calluses (a buildup of skin) on the toe, between two toes, or on the ball of the foot.
  • Sharp burning pain, aching pain or numbness to the toes.
  • Contracture of the toe. Flexible or rigid.
  • Thickening of the nail.
  • Toes crossing over each other.

Conservative Treatment of Hammer Toe:

Non surgical treatment can be more successful when the contracture of the toe is flexible (reducible).

  • Changes in shoewear. Use shoes with a larger in both width and height of toe box. This will reduce pressure on the toes. Avoid high heeled shoes.
  • Orthotic devices. A custom orthotic device or an appropriate over the counter orthotic device.
  • Injection therapy. Cortisone injections can be considered. However, they may also cause the deformity to progress more rapidly. Discuss with your physician the risks and benefits of the injections.
  • Padding: padding the toes
  • Splinting or taping
  • Stretching

Surgical treatment of Hammer Toe:

This should be considered once the toe has become rigidly contracted and conservative care has failed. Your physician will need to evaluate your foot and the etiology of your toe contracture. Surgical treatment will vary pending the etiology. Please discuss the details with your physician.

We encourage you to consult with a foot and ankle specialist for a complete assessment of your condition.