Hammer Toe Overview
A fixed contracture of the lesser toes at the proximal joint is known as a hammer toe. These toe deformities usually start off flexible but over time they can become rigid and lose movement. The toes begin rubbing in shoes and the limited movement can become painful. There can be several causes of this conditions including: imbalanced pull from the muscles in the foot (intrinsic and extrinsic muscles), crowding of the toes in shoes, and some medical conditions such as neuropathy or Charcot-Marie-Tooth Disease.
Symptoms of Hammer Toes
When the toes are bent in an abnormal position they can become painful. The toes can rub in shoes that may create blisters or corns. Flexion of the toes can pull the fat pad (cushion) over the metatarsal heads distally causing widespread forefoot pain.
Diagnostic Testing for Hammer Toes
Our physicians will conduct an extensive clinical examination (evaluating rigidity and angulation of the toe) as well as x-rays. These together will determine the best course of treatment for the toe deformity present.
Treatment of Hammer Toes
Non-Surgical Treatment of Toe Deformities
Taping or splinting the toes can treat mild cases of toe deformity. This is used to help reduce further deformity and minimize symptoms. Toe exercises to improve strength and flexibility may also be prescribed.
Surgical Treatment for Hammer Toes
For severe hammer toe deformity, surgery may be needed to correct the condition. Depending on the rigidity of the deformity and angulation of the toes, the appropriate surgical procedure is selected. In some cases it necessary to lengthen or shorten tendons and/or ligaments to help improve mobility and laxity. To prevent recurrence, a fusion may also be needed to connect the bones on each side of the joint. The bones can be fused with a removable wire or with a metallic implant. Most of these surgeries are consider outpatient and following physical therapy, patients are able to resume their normal activities.
Post-Operative Care for Hammer Toes
It is essential that patients follow the post-operative protocol for recovery set forth by our team as it remains a crucial part of the healing process. Depending on the specific procedures performed, patients can typically heel weight bear in a hard sole (postoperative) shoe almost immediately. An assistive device such as crutches are usually needed for the first few days to weeks. Dressing are placed over the forefoot and this will be changed by our team the first postoperative clinic visit.