Hammer, claw, and mallet toes are toes that do not have the right shape. They may look odd or may hurt, or both. Tight shoes are the most common cause of these toe problems. A Hammer toe
is a toe that bends down toward the floor at the middle toe joint. It usually happens in the second toe. This causes
the middle toe joint to rise up. Hammer toes often occur with bunions. Claw toe often happens in the four smaller toes at the same time. The toes bend up at the joints where the toes and the foot
meet. They bend down at both the middle joints and at the joints nearest the tip of the toes. This causes the toes to curl down toward the floor. A mallet toe often happens to the second toe, but it
may happen in the other toes as well. The toe bends down at the joint closest to the tip of the toe.
Hammer toe results from shoes that don?t fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe
is bent and held in one position long enough, the muscles tighten and cannot stretch out. Some other causes are diabetes, arthritis, neuromuscular disease, polio or trauma.
Here is a look at some of the symptoms hammertoe can cause. They include hammer-like or claw-like appearance of the toe. Pain when walking or moving the foot. Difficulty moving the toe. Corns may
form on hammertoes
top of the toe. Callus may form on the sole of the foot. During the initial
stages, you may be able to manually straighten your toe. This is called a flexible hammertoe. But as time passes, the toe will not move as easily and will continue to look like a hammer. Pressure and
irritation over the joint can cause a blister to develop and become a corn over time. These corns have the potential to become infected and cause additional symptoms such as redness, bleeding, and
difficulty wearing shoes and socks. Corns are the main cause of pain when hammertoes are developing.
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
You can usually use over-the-counter cushions, pads, or medications to treat bunions and corns. However, if they are painful or if they have caused your toes to become deformed, your doctor may opt
to surgically remove them. If you have blisters on your toes, do not pop them. Popping blisters can cause pain and infection. Use over-the-counter creams and cushions to relieve pain and keep
blisters from rubbing against the inside of your shoes. Gently stretching your toes can also help relieve pain and reposition the affected toe.
There are several surgical methods to correct a hammer toe. Your physician will decide which method will be most beneficial to you depending on the severity of your deformity, the direction the toe
is deviating and the length of the affected toe. Some common surgical methods include. Arthroplasty. To promote straightening, half of the joint located directly underneath the crooked part of the
toe is removed. Arthrodesis (fusion) To promote straightening, the joint directly underneath where the toe is crooked is completely removed. A wire or pin is inserted to aid healing. Tendon transfer.
Performed alone or in combination with other procedures, a surgeon will take tendons from under the toe and ?re-route? them to the top of the toe to promote straightening. Basal phalangectomy.
Performed to assist patients with severe stiffness, this procedure removes the base of the bone underneath the toe. Weil osteotomy. Performed to assist patients with severe stiffness, this procedure
involves shortening the metatarsal bone and inserting surgical hardware to aid healing.
As you get older, feet get bigger. Get your feet measured every time you buy shoes. Don't go by shoe sizes. Shoe sizes vary among manufacturers; a shoe is the right size only when it fits
comfortably. The ball of your foot should fit into the widest part of the shoe. A shoe should be sturdy such that it only bends in the ball of the foot, exactly where your big toes bend. Any shoe
that can be bent anywhere along the sole or twisted side to side is generally too flimsy.