A hammertoe refers to a toe that is contracted or curled downward at the middle joint of the toe. Hammertoes can occur at any of the toes, except the great toe, and is most common in the second toe. There are two types of hammer toes:
Rigid hammertoe – The tendons of the toe become contracted, leading to mal-alignment and immobility. This can place added stress on the ball of foot.
Flexible hammertoe – The toe becomes contracted, but has the ability to move.
Common symptoms of hammertoes include pain along the affected joint, corns, calluses, redness of the contracted toe, and loss of mobility.
Hammertoes are caused by a muscle imbalance in which the tendons become excessively tight. Injuries (trauma) to the toe(s), genetics, arthritis, and tight shoe wear can also be a contributing cause of hammertoe deformity.
The diagnosis of a hammertoe is made by physical examination from a trained orthopaedic surgeon. Typically, an immediate change in shoe wear is recommend to increase room surrounding the toes. Hammer toe pads and splints may also be recommended to alleviate some of the pressure. Non-steroidal anti-inflammatory (NSAID) medications may be prescribed to help treat the inflammation and manage pain.
Surgical treatment may be recommended for those do not improve with conservative measures. The goal of surgery is to alleviate pain, correct the deformity, and allow for resumption of regular daily activities. A hammertoe correction involves removing the bony prominence on the toe and realigning the joint. In some cases, a tendon transfer may be necessary.