What are Hammertoes?

                Hammertoes are lesser toes that are shaped like a ‘hammer’. It is a deformity of the toes that starts at the middle joint with a contracture. The toes curl downward and often have difficulty straightening out. Initially, the toe deformity can straighten due to the flexibility of the toe, but if left untreated, can lead to a boney issue and become rigid.

What causes Hammertoes?

                Hammertoes are caused by a multitude of different pathologies. The main cause is muscle imbalance. There are many smaller muscles that originate from the foot that attach to the toes that help them contract and function properly. There are also muscles that originate from the calf that are much larger and have a much more prominent force on the toes. These tend to balance each other out if proper biomechanics of the foot are maintained. However, improper shoe gear such as tight-fitting shoes or high heels, or even going barefoot can accentuate this muscle imbalance and cause improper biomechanics. This ultimately results in the larger muscles overpowering the smaller foot muscles causing them to contract abnormally, resulting in hammertoes.

What are the symptoms of Hammertoes?

                There are many symptoms associated with hammertoes that vary depending on how severe they may be. Some may experience mild symptoms or no symptoms at all, while others may experience disabling symptoms. These may include, but are not limited to:

• Pain
• Redness
• Stiff toe
• Corns or calluses
• Nail pain or deformity
• Difficulty with balance or walking

How to treat Hammertoes?

                There are several different approaches and modalities to treat hammertoes that all vary on the severity of the deformity and how symptomatic they are. There are conservative treatments as well as surgical options. Conservatively, hammertoes can be treated with straps, pads, or splints. Making sure one has the appropriate shoe gear to accommodate the deformity is paramount. One should make sure to manage the corns and calluses if present to prevent further irritation and breakdown of the skin that may cause ulceration and possible infection. Surgical intervention also varies depending on multiple factors. One of Dr. Nelson’s most utilized options is a tenotomy and capsulotomy procedure for flexible hammertoes. This can often be done same day in-office and patient outcomes are quite satisfactory. Other options include removal of bone spur (arthroplasty), fusion of the affected joint (arthrodesis), and occasionally tendon transfer or intramedullary implant. The goal of surgical correction is pain relief and return to activity with resolve of prior symptoms.