A Hammer toes
or contracted toe is a deformity of the proximal interphalangeal joint of the second,
third, or fourth toe causing it to be permanently bent, resembling a hammer. Mallet toe is a similar condition affecting the distal interphalangeal joint. Claw toe is another similar condition, with
dorsiflexion of the proximal phalanx on the lesser metatarsophalangeal joint, combined with flexion of both the proximal and distal interphalangeal joints. Claw toe can affect the second, third,
fourth, or fifth toes.
A common cause of hammertoe and mallet toe is wearing improper footwear - shoes that are too tight in the toe box, or high-heel shoes. Wearing shoes of either type can push your toes forward,
crowding one or more of them into a space that's not large enough to allow your toes to lie flat. Hammertoe and mallet toe deformities can also be inherited and may occur despite wearing appropriate
footwear. The result is a toe that bends upward in the middle and then curls down in a hammer-like or claw-like shape. Your shoes can rub against the raised portion of the toe or toes, causing
painful corns or calluses. The bottom of the affected toe can press down, creating the mallet-like appearance of mallet toe. At first, a hammertoe or mallet toe may maintain its flexibility and lie
flat when you're not wearing crowded footwear. But eventually, the tendons of the toe may contract and tighten, causing your toe to become permanently stiff.
src='http://ugloworthopaedics.com/wp-content/uploads/2013/08/Multiple-Weils.jpg' width='254' alt='Hammer Toe'/>Symptoms
Some people never have troubles with hammer toes. In fact, some people don't even know they have them. They can become uncomfortable, especially while wearing shoes. Many people who develop symptoms
with hammer toes will develop corns, blisters and pain on the top of the toe, where it rubs against the shoe or between the toes, where it rubs against the adjacent toe. You can also develop calluses
on the balls of the feet, as well as cramping, aching and an overall fatigue in the foot and leg.
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some
types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe.
Non Surgical Treatment
A person with hammer toes will be asked to practice some exercises for their toes to regain average structure and movement. The exercises usually involve stretching and strengthening their toes. The
person may attempt to pick things up off the floor using only their toes. They may also stretch their toes on a regular basis by hand to ease them into straightening out. Another example of a
physical exercise specifically for a person's toes involves crumpling a towel with the toes. The towel can lie underneath the person's feet and the person can use their toes to scrunch up the towel
as they perform simple tasks such as reading a book or watching television.
Surgery is the approach that is often necessary to correct hammertoe that fails to respond to nonsurgical management. Surgery is appropriate when the muscles and tendons involved in a hammertoe
problem have become so tight that the joints are rigid, misaligned and unmovable. There are a number of surgical techniques for dealing with the complex range of joint, bone, muscle, tendon and
ligament abnormalities that define each hammertoe's make-up. To correct a hammertoe deformity, the surgeon's goal is to restore the normal alignment of the toe joint, relieving the pressure that led
to the hammertoe's development (this should also relieve the pain, as well). To do this, he or she may remove part of the boney structure that creates a prominence at the top of the joint. Tighten or
loosen the muscles, tendons and ligaments around the toe joints. Realign the toe bones by cutting one or more and shifting their position, realigning muscles, tendons and ligaments accordingly. Use
screws, wires or plates to hold the joint surfaces together until they heal. Reconstruct a badly damaged joint or replace it with an artificial implant.