Hammer Toe
Our foot is made up of five toes with each toe comprising of three joints (except for the big toe) to allow toe movement. In a hammer toe, the affected toe is bent at the middle joint (or proximal interphalangeal joint), and usually occurs in the second, third or fourth toes. If left untreated, a hammer toe can become fixed and will require surgery to correct it.
Symptoms
A hammer toe is painful and can make it difficult to wear shoes.
Other symptoms include:
- Swelling or redness
- Inability to straighten the toe
- Difficulty walking
- A corn or callus on the top of the middle joint of the toe or on the tip of the toe
Causes
Wearing shoes that do not fit properly results in muscle imbalance, putting pressure on the toe tendons and joints – resulting in the toe being bent for a long period of time. The toes also rub against the shoe, forming corns and calluses on the top or tip of the toe, which further aggravates the condition. High heels push the foot down and toes against the shoe, increasing pressure and bending in the toe. Eventually, the toe muscles can no longer straighten the toe, and the soft tissue surrounding the toe joints stiffen up, resulting in a fixed deformity.
Diagnosis
Your orthopaedic specialist will start off with a physical examination to determine if the toe joint is flexible or rigid. You may also be required to undergo an X-ray to check for arthritis or previous bony injuries.
Treatment
Non-surgical treatments are typically considered in the early stages of a hammer toe when the joint is still flexible. They include changing your footwear to avoid wearing high heels, and to wear shoes with a wide or deep toe box. You can also do physical therapy, involving exercises to stretch the toes, and strengthen the foot muscles such as toe curls. If there is significant pain or inflammation, anti-inflammatory medication can help.
If you are not responding to conservative measures, your orthopaedic specialist may recommend surgery. For flexible deformities, this may involve lengthening or transferring the tendons to the toe to treat the muscle imbalance and straighten the toe deformity. If the deformity is fixed, usually a fusion is required, where your orthopaedic surgeon will remove the cartilage and bone around the toe joint and fix the bones together.
Every case is different; hence it is best to consult an orthopaedic specialist for an accurate diagnosis so that you can obtain the best treatment option that is most suitable for you. Reach out to us today if you suspect you are suffering from a hammer toe and let us help you enjoy a better quality of life.
