Symptoms: hammertoes can be non-painful or painful. They may or may not have a corn or callus associated with the toe and associated metatarsal. There may only be redness and irritation. The toe will be lifted up and either bent at one, two or three joints. These hammertoes may be very rigid or somewhat flexible.
How this happens: Often there is a change in the pull of the tendons on the top and the tendons on the bottom of the foot. They can also occur from the bunion problem. A high arch foot will often have hammertoes as well. Shoes can also be a factor if they are too tight. For many people, this is not an overnight change but occurs over many decades.
What to do: Try different shoes. If the shoe is too tight there will not be enough room in the toe box and the hammertoe can easily be irritated. High heels are also to be avoided as it increases the amount of pressure to the toes and worsens the deformity.
There are different types of pads that can be helpful for hammertoes. One such pad is a silicone gel tube that fits over the toe like a sock. Another type is a crest pad. This type of pad is helpful in lifting the tip of the toe up in the air in case there is a callous at the end of the toe. Foam spaces can be used if the hammertoe is rubbing with another toe.
Click here to learn how to treat a corn or callus associated with a hammer toe
What can a podiatrist do for you? A Podiatrist can help get you in the right pad and help make sure that your shoes are properly fitted. A foot doctor can also help manage any corns or calluses by shaving them and keeping them well debrided.
Pictures can also be taken to evaluate the degree and to better understand the underlining cause of the hammertoe. Joints can be examined.
If you have a hammer toe that is flexible and the conservative treatments are ineffective there are several surgical options for you. One such option that works well in diabetics or the elderly patients is a flexor tenotomy, in which the tendon is released with a small stab under the toe. A stitch isn’t even necessary for this procedure and healing is pretty uneventful the majority of the time.
If the hammertoe is rigid then the surgery of choice would be a fusion of the affected joint. Fixation for this type of procedure is usually done with an implant that fits inside the bone, but can also be done with pins or screws. Occasionally other work will need to be done to the associated metatarsals to bring the toe back into a straight position.
Results: Conservative therapy the majority of patients can be very effective and manage the condition the best they can. The flexor release of the attending can also be very effective if you are the right patient for the procedure. Fusions can also be effective but can also take longer to heal and can leave the toes swollen and painful for a longer period of time as it heals.