is caused when the middle joint (PIP) bends down towards the floor (flexion). To
compensate, the joints above and below (MTP, DIP) bend up (hyperextend). The result is that the middle part of the toe lifts up. Hammertoe is the most common deformity of the lesser toes (i.e. not
the big toe). It tends to only affect one toe, most commonly the second.
Wearing shoes that squeeze the toes or high heels that jam the toes into the front of the shoe. Other causes or factors in the development of hammertoes can include an injury such as badly stubbing
your toe, arthritis and nerve and muscle damage from diseases such as diabetes. And, hammertoes tend to run in families, although it is more likely the faulty foot mechanics that lead to hammertoes
that are inherited, not the hammertoes themselves. Hammertoe generally affect the smaller toes of the foot, especially the second toe, which for many people is the longest toe. It's uncommon for the
big toe to be bent this way.
A soft corn, or heloma molle, may exist in the web space between toes. This is more commonly caused by an exostosis, which is basically an extra growth of bone possibly due to your foot structure. As
this outgrowth of excessive bone rubs against other toes, there is Hammer toes
friction between the toes
and a corn forms for your protection.
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination,
the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the
degree of the deformities and assess any changes that may have occurred.
Non Surgical Treatment
A number of approaches can be undertaken to the manage a hammer toe. It is important that any footwear advice is followed. The correct amount of space in the toe box will allow room for the toes to
function without excessive pressure. If a corn is present, this will need to be treated. If the toe is still flexible, it may be possible to use splints or tape to try and correct the toe. Without
correct fitting footwear, this is often unsuccessful. Padding is often used to get pressure off the toe to help the symptoms. If conservative treatment is unsuccessful at helping the symptoms,
surgery is often a good option.
Treatment of a severe hammertoe that has become rigid includes surgery. What is done during the surgery depends on how misshapen and inflexible the toe is. The surgeon may make a cut over your toe
and release the tendon by cutting the tendon away from the bone. The surgeon may remove a small piece of bone from the toe. The surgeon may realign the tendons to reposition your toe or fasten the
bones with pins. Sometimes the surgeon may have to join the bones in the toe. In this case, you will no longer be able to bend the toe, but the toe will be flat.
Custom orthotics paired with a well made shoe can prevent the progression and development of hammertoes. Wearing proper-fitting shoes and custom orthotic devices can provide the support patients need
to address muscle/tendon dysfunction. It can also support end stage diseases that result in hammertoe deformities by re-balancing the foot and ankle and controlling the deforming forces.