Non Surgical Hammer Toe Repair

Overview

A hammertoes is a term that is commonly used to describe any type of toe deformity. It is a common problem that may or may not be a problem. What does a hammer toe look like? In a hammertoe the deformity usually exists in one toe (at the proximal inter phalangeal joint) - the base of the toe points upward and the end of the toe points down.

Causes

Hammer toe is often caused by wearing shoes that hammertoe 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.

Symptoms

Signs and symptoms of hammertoe and mallet toe may include a hammer-like or claw-like appearance of a toe. In mallet toe, a deformity at the end of the toe, giving the toe a mallet-like appearance. Pain and difficulty moving the toe. Corns and calluses resulting from the toe rubbing against the inside of your footwear. Both hammertoe and mallet toe can cause pain with walking and other foot movements.

Diagnosis

Your healthcare provider will examine your foot, checking for redness, swelling, corns, and calluses. Your provider will also measure the flexibility of your toes and test how much feeling you have in your toes. You may have blood tests to check for arthritis, diabetes, and infection.

Non Surgical Treatment

If the affected toe is still flexible, you may be able to treat it by taping or splinting the toe to hold it straight. Your family doctor can show you how to do this. You may also try corrective footwear, corn pads and other devices to reduce pain. You may need to do certain exercises to keep your toe joints flexible. For example, you may need to move and stretch your toe gently with your hands. You can also exercise by picking things up with your toes. Small or soft objects, such as marbles or towels, work best. If your hammer toe becomes painful, you may need to apply an ice pack several times a day. This can help relieve the soreness and swelling. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen (two brand names: Advil, Motrin) or naproxen (one brand name: Aleve), may be helpful. If your pain and swelling are severe, your doctor may need to give you a steroid injection in the toe joint.

Surgical Treatment

Bone-mending procedures realign the contracted toe by removing the entire deviated small joints of the toe (again, not at the ball of the foot). This allows for the buckled joint to be positioned flat and the bone ends to mend together. Often surgical hardware (fixation) is necessary to keep the bones steady during healing. Hardware options can involve a buried implant inside the toe, or a temporary wire that is removed at a later date. Medical terminology for this procedure is called a proximal interphalangeal joint arthrodesis (fusion), or a distal interphalangeal joint arthrodesis (fusion), with the former being performed in a high majority of cases.

Prevention

The easiest way to avoid hammertoe is to wear shoes that fit properly. Orthopaedic surgeons and podiatrists recommend shoes that have roomy toe boxes, which give the toes plenty of space to flex. Shoes that fit well should also cushion the arch in the middle of the foot. This helps to distribute the weight of the body evenly across the bones and joints of the foot. The size and shape of a foot can change with age, and many people inadvertently wear the wrong size shoe. Podiatrists recommend having your feet measured regularly to ensure that your shoes fit properly.