Podiatrists @ Placentia-Linda Foot & Ankle Group

HAMMERTOE DEFORMITY

CAUSES AND TREATMENT

WHAT ARE HAMMERTOES?

Hammertoes are a common podiatry digital deformity where the middle of the toe bends upward causing foot pain. The hammertoe deformity is caused by a muscle imbalance in the foot where the muscles in the leg are trying to stabilize the foot during walking or the muscle are trying to help with a weak Achilles' Tendon. Once the hammertoe deformity begins to form, the deformity is progressive in nature and will eventually become a rigid fixed deformity. Because the center of the toe is bending upward, the toe commonly develops a callous on top of the toe that is painful. Also associated with hammertoe deformities is a callous under the ball of the foot due do the hammertoe causes the metatarsal head in the ball of the foot to drop down. The hammertoe deformity can occur to all toes or only one toe. Usually the second through fifth toes are involved. Besides hammertoes, there are other related toe deformities such as a mallet toe deformity where the end joint in the toe bends down and a claw toe where both toe joints are bent down and the toe looks curled down.

TREATMENT CONSIDERATIONS:

Treatment for hammertoes consists of trying to help improve the muscle balance in the foot by wearing more supportive shoes and a hammertoe pad. A custom molded foot orthotic may be recommended by a Podiatrist after examination of your foot to help decrease the amount of muscle pulling occurring to the end of the toes. The use of certain pads do help especially a pad called a Buttress Pad that you can buy at the store or a custom pad can be made for you by a Podiatrist. When the hammertoes become a constant problem in trying to use padding around the toes and nothing is working, surgical straightening of the toe or toes is indicated. There a few different procedures that are used to correct hammertoe deformities. The two most common is the Joint Arthroplasty and Joint Fusion. Joint Arthroplasty is a procedure that removes the largest part of the middle joint in the toe to allow the toe to straighten out.  A Joint Fusion is where the middle joint is fused using various fusion techniques.  An excellent method of fusion is to use an absorbable pin that is placed in the middle of the toe bones that after the fusion has taken will be dissolved in about six months.  Depending on the amount of lifting that has resulted in the ball of the foot from the hammertoe deformity, both an arthroplasty and a fusion may require the additional procedure of a release of the joint contracture in the joint at the ball of the foot.  Ultimately, regardless of the method used to correct the hammertoe deformity, after surgery, the patient should expect a good result and should not experience any major pain from the toe surgery.  Usually if the second through fifth toes have a hammertoe deformity, the typical treatment is to fuse the second through forth toes and to perform a arthroplasty on the fifth toe.

In summery, hammertoe deformities are very common and are initially treated with supportive shoes and / or foot orthotics and the use of a Buttress Pad. Depending on the severity of the pain that is occurring in the toe and the amount of callous formation at the top of the toe and under the ball of the foot, surgical intervention may be required to straighten the toe and resolve the joint contracture that is occurring at the joint in the ball of the foot.