Hammer toes are classified based on the mobility of the toe joints. There are two types. Flexible and rigid. In a flexible hammertoe
, the joint has the ability to move. This type of hammer
toe can be straightened manually. A rigid hammer toe does not have that same ability to move. Movement is very limited and can be extremely painful. This sometimes causes foot movement to become
restricted leading to extra stress at the ball-of-the-foot, and possibly causing pain and the development of corns and calluses.
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.
If the toes remain in the hammertoe position for long periods, the tendons on the top of the foot will tighten over time because they are not stretched to their full length. Eventually, the tendons
shorten enough that the toe stays bent, even when shoes are not being worn. The symptoms of hammertoe include a curling toe, pain or discomfort in the toes and ball of the foot or the front of the
leg, especially when toes are stretched downward, thickening of the skin above or below the affected toe with the formation of corns or calluses, difficulty finding shoes that fit well. In its early
stages, hammertoe is not obvious. Frequently, hammertoe does not cause any symptoms except for the claw-like toe shape.
The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear
crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at
the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still
flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the
involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.
Non Surgical Treatment
Podiatric Care may include using anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce this swelling. When you go to your doctor, x-rays are usually required
to evaluate the structure of your foot, check for fractures and determine the cause. The podiatrist may see you to take care of any corns that develop due to the bone deformities. They may advise you
on different shoewear or prescribe a custom made orthotic to try and control the foot structure. Padding techniques may be used to straighten the toe if the deformity is flexible, or pads may be used
to lessen the pressure on the area of the corn or ulcer. Your podiatric physician may also recommend a surgical procedure to actually fix the structural problem of your foot.
he basis for hammer toe surgery most often involves removing s portion of bone within the toe, to reduce the joint contracture. Depending on the direction the toe is deviated, soft tissue procedures
may be necessary along with pinning the toe with a surgical wire.
elect and wear the right shoe for specific activities (such as running shoes for running). Alternate shoes. Don't wear the same pair of shoes every day. Avoid walking barefoot, which increases the
risk for injury and infection. At the beach or when wearing sandals, always use sunblock on your feet, as you would on the rest of your body. Be cautious when using home remedies for foot ailments.
Self-treatment can often turn a minor problem into a major hammertoe
one. It is critical that people
with diabetes see a podiatric physician at least once a year for a checkup. People with diabetes, poor circulation, or heart problems should not treat their own feet, including toenails, because they
are more prone to infection.