Hammertoe

What Is Hammertoe?

Hammertoe is a contracture (bending) deformity of one or both joints of the second, third, fourth or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.

Normal toes unaffected by hammertoeHammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with noninvasive measures. But if left untreated, hammertoes can become more rigid and will not respond to nonsurgical treatment.

Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.

Causes

The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) or neurological changes in the foot that occur over time in some people.

Hammertoes may be aggravated by shoes that do not fit properly. A hammertoe may result if a toe is too long and is forced into a cramped position when a tight shoe is worn. Occasionally, hammertoe is the result of an earlier trauma to the toe. In some people, hammertoes are inherited.

Symptoms

Common symptoms of hammertoes include:

• Pain or irritation of the affected toe when wearing shoes.
• Corns and calluses (a buildup of skin) on the toe, between two toes or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending on their location.
• Inflammation, redness or a burning sensation
• Contracture of the toe
• In more severe cases of hammertoe, open sores may form.

Diagnosis

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.

Hammertoes are progressive-they do not go away by themselves and usually they will get worse over time. However, not all cases are alike-some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.