is a Z-shaped deformity caused by dorsal subluxation at the
metatarsophalangeal joint. Diagnosis is clinical. Treatment is modification of footwear and/or orthotics. The usual cause is misalignment of the joint surfaces due to a genetic predisposition toward
aberrant foot biomechanics and tendon contractures. RA and neurologic disorders such as Charcot-Marie-Tooth disease are other hammertoes
While most cases of hammertoes are caused by an underlying muscle imbalance, it may develop as a result of several different causes, including arthritis, a hereditary condition, an injury, or
ill-fitting shoes. In some cases, patients develop hammertoes after wearing shoes or stockings that are too tight for long periods of time. These patients usually develop hammertoes in both
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.
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.
Hammertoe surgery is performed when conservative measures have been exhausted and pain or deformity still persists. The surgery is performed on an outpatient basis. It typically required about one
hour of time. An incision is placed over the inter-phalangeal joint. Once the bone is exposed, the end portion of the bone is removed. Your surgeon may then use pins or other fixation devices to
assist in straightening the toe. These devices may be removed at a later date if necessary. Recovery for hammertoe surgery is approximately 10 to 14 days. You are able to walk immediately following
the surgery in a surgical shoe. Swelling may be present but is managed as needed. Physical therapy is used to help reduce swelling in the toe or toes after surgery. Most of these toe surgeries can be
performed in the office or the outpatient surgery under local anesthesia.
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.