What are hammertoes, mallet toes and claw toes? Often the words are used interchangeably to mean an abnormally contracted toe like the drawing above. Technically speaking, a "hammertoe" is the name for a toe that is contracted at the first toe joint. If it's contracted at the second toe joint it is called a "mallet toe". IIf a toe is contracted at both toe joints, it is called a "claw toe". Each of these conditions can be quite uncomfortable and are cosmetically unappealing.
Hammer toe is often caused by wearing shoes that do not fit properly. If shoes are too small either in length or width, then the toes are held in a shortened position for long periods and the muscles eventually shorten and pull the toes into the bent position. Alternatively it can be caused by overactivity in the extensor digitorum dongus muscle (right) and a weakness in the counteracting muscle under the foot, such as flexor digitorum longus. Sometimes it can be a congenital condition, meaning it is present from birth. It is also more common in those with arthritis in the foot or diabetes.
The most common symptoms of hammertoes include. The toe is bent upward at the middle toe joint, so that the top of this joint rubs against the top of the shoe. The remainder of the toe is bent downward. Pain upon pressure at the top of the bent toe from footwear. The formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of the toe joint. Pain in the ball of the foot at the base of the affected toe. This occurs because the contracted digit puts pressure on the Hammer toe metatarsal head creating callouse and pressure on the ball of the foot.
Hammer toes may be easily detected through observation. The malformation of the person's toes begin as mild distortions, yet may worsen over time - especially if the factors causing the hammer toes are not eased or removed. If the condition is paid attention to early enough, the person's toes may not be permanently damaged and may be treated without having to receive surgical intervention. If the person's toes remain untreated for too long, however the muscles within the toes might stiffen even more and will require invasive procedures to correct the deformity.
Non Surgical Treatment
Your podiatrist may recommend one or more of these treatments to manage your hammer toes. Wear shoes with roomy toe boxes which don?t force your toes together. Exercises to stretch and strengthen muscles in the toes. Over the counter toe straps, cushions, and corn pads. Custom orthotic inserts. Toe caps or toe slings. In severe cases, surgery to release the muscles in the affected toes.
Surgical correction is needed to bring the toe into a corrected position and increase its function. Correction of the hammer toes is a simple outpatient surgery, with limited downtime. The best option is to fuse the deformed and contracted toe into a straight position. This limits the need for future surgery and deformity return. A new pin that absorbs in the bone or small screw is used by the Foot and Ankle Institute to avoid the need for a metal pin protruding from the toe during recovery. Although the absorbable pin is not for everyone, it is much more comfortable than the pin protruding from the end of the toe. In certain cases, a removal of a small area of bone in the deformity area will decrease pain and limit the need for a surgical waiting period that is found with fusions. Although the toe is not as stable as with a fusion, in certain cases, an arthroplasty is the best option.
The key to prevention is to wear shoes that fit you properly and provide plenty of room for your toes. Here?s how to get the right fit. Have your feet properly measured. The best way to do this is to get someone to draw the outline of your foot while you stand barefoot with your full weight on it, then measure the outline at the widest point. Measure the soles of your shoes. Ideally, they should be as wide as your feet, but certainly no more than half an inch narrower. Length matters, too, of course: your shoes should be half an inch longer than your longest toe.