A Hammer toe
a contracture of the toes as a
result of a muscle imbalance between the tendons on the top and the tendons on the bottom of the toe. They can be flexible or rigid in nature. When they are rigid, it is not possible to straighten
the toe out by manipulating it. Frequently, they develop corns on the top of the toe as a result of rubbing on the shoe. They may also cause a bothersome callous on the ball of the foot. This occurs
as a result of the toe pressing downward on the bone behind the toe. This area then becomes prominent and the pressure of the bone against the ground causes a callous to form.
The constant pressure a woman's foot receives in high-heeled shoes due to the force of gravity causes their feet to naturally slide down and press on the lowest point of the shoe so they are not able
to receive enough space and stretch out. The result is an eventual distortion of the woman's toes. The deformity comes as a result of the shortening of muscles inside the toes because the toes become
used to being in a bent position, prompting the muscles to fail to extend any further and become tightened and curbed. At first, toes may still be stretched out if poor footwear is not being worn,
yet if the habit is persistent...the person's toes will eventually become used to the position they are constantly in and muscle fibers inside them will harden and refuse to stretch.
The symptoms of hammertoe are progressive, meaning that they get worse over time. Hammertoe causes the middle joint on the second, third, fourth, or fifth toes to bend. The affected toe may be
painful or irritated, especially when you wear shoes. Areas of thickened skin (corns) may develop between, on top of, or at the end of your toes. Thickened skin (calluses) may also appear on the
bottom of your toe or the ball of your foot. It may be difficult to find a pair of shoes that is comfortable to wear.
Your healthcare provider will examine your foot, checking for redness, swelling, corns, and calluses. Your provider will also measure the flexibility of your toes and test how much feeling you have
in your toes. You may have blood tests to check for arthritis, diabetes, and infection.
Non Surgical Treatment
If the affected toe is still flexible, you may be able to treat it by taping or splinting the toe to hold it straight. Your family doctor can show you how to do this. You may also try corrective
footwear, corn pads and other devices to reduce pain. You may need to do certain exercises to keep your toe joints flexible. For example, you may need to move and stretch your toe gently with your
hands. You can also exercise by picking things up with your toes. Small or soft objects, such as marbles or towels, work best. If your hammer toe becomes painful, you may need to apply an ice pack
several times a day. This can help relieve the soreness and swelling. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen (two brand names: Advil, Motrin) or naproxen
(one brand name: Aleve), may be helpful. If your pain and swelling are severe, your doctor may need to give you a steroid injection in the toe joint.
For the surgical correction of a rigid hammertoe, the surgical procedure consists of removing the damaged skin where the corn is located. Then a small section of bone is removed at the level of the
rigid joint. The sutures remain in place for approximately ten days. During this period of time it is important to keep the area dry. Most surgeons prefer to leave the bandage in place until the
patient's follow-up visit, so there is no need for the patient to change the bandages at home. The patient is returned to a stiff-soled walking shoe in about two weeks. It is important to try and
stay off the foot as much as possible during this time. Excessive swelling of the toe is the most common patient complaint. In severe cases of hammertoe deformity a pin may be required to hold the
toe in place and the surgeon may elect to fuse the bones in the toe. This requires several weeks of recovery.
The best ways to prevent a hammertoe are. Wear shoes that fit well. Shoes should be one-half inch longer than your longest toe. Shoes should be wide enough and the toe box should be high enough to
give the foot room to move. Don?t wear shoes with heels over 2 inches high. If a toe starts to look like a hammertoe, buy shoes that have an extra high toe box. Wear corn pad removers or cushion pads
on top of the affected toe. See your healthcare provider any time you have foot pain that does not go away quickly or is more than mild pain. Foot pain is not normal.