A Guide to Hammertoes
A Hammertoe is a condition in which the middle joint in the toe gets rigid and fixed. In some cases, the deformed joint looks like a hammer. This can happen in the second, third, or fourth toes.
In many cases, a corn or callus develops at the top of the middle joint or the proximal interphalangeal (PIP) joint. Instead of being flat on the ground, the joint points up and appears deformed. In fact, toes that curl are also considered hammertoe.
Generally, the condition is classified into three categories:
- If you can still move the joint, it is flexible hammertoes. In this case, the problem is at a preliminary stage, and there are multiple options for treatment.
- When the hammertoe starts to harden, the condition is a semi-rigid hammertoe.
- If the tendons have hardened, it is a rigid hammertoe. At this stage, the toe can not be moved, and surgery is the only remedy.
What are the Symptoms?
Here are some of the common symptoms of hammertoes:
- Pain and inflammation in the affected area. This can cause difficulty while walking or when wearing shoes.
- Formation of corns or calluses on the toe or between two toes. At times, corns can also develop on the ball of the foot. These are caused due to the constant friction of the deformed areas against the shoe. Based on the conditions and location, the corns can be hard or soft.
- Redness in the affected area, accompanied by irritation or a burning sensation.
- Contracture of the affected toe and difficulty in moving it. Usually, the stiffness and soreness get worse with time.
- In some severe cases, the skin might break and cause open sores.
What Causes Hammertoes?
The main cause behind hammertoes is an imbalance in the surrounding muscles and tendons. Any imbalance in the muscles puts extra pressure on the tendons and the joints. This pressure leads to the deformation of the toe.
Take a look at the main causes:
- The joint deformity can be due to genetic factors that determine your foot type. In people with a flat arch, the toes may get deformed as the feet try to find more stability. In the case of people with high arches, the imbalance between the extensors and flexor tendons can lead to hammertoes.
- Wearing narrow and ill-fitting shoes can put extra pressure on the toe joints and tendons. When a long toe is forced into a cramped position for hours, it can get deformed. Wearing high heels is another major cause behind hammertoes.
- Patients with neuromuscular disorders can start developing a hammertoe. Those with diabetes and poor blood flow are more susceptible to complications from the corns forming on a hammertoe.
- Conditions like Charcot-Tooth-Marie disease, arthritis, and spinal cord tumors can also cause hammertoes.
Apart from the above causes, severe trauma to the toe due to accidents can also cause a hammertoe.
How are Hammertoes Treated?
Hammertoes do not go away by themselves and are progressive in nature. That means they usually get worse with time. However, the rate of progress can differ in each case.
The good news is that there are various steps you can take to reduce the symptoms of hammertoes. Here are some of them:
- Wearing comfortable and roomier shoes to reduce stress on the toes.
- Special exercises to stretch the toes and release stress on the muscles and tendons.
- Custom Orthotics to offload the pressure on your toes.
- Splinting or taping the toe to reduce the deformation.
- Using anti-inflammatory drugs to control the pain and swelling. If the pain is severe, steroidal injections are also used.
In severe cases, the doctor can suggest surgery to cure a hammertoe. Multiple surgical options are effective for treating the condition.
- Arthroplasty or replacing a part of the damaged joint with a prosthesis. In more severe cases, Arthrodesis is done. Here, the dysfunctional joint is removed, and internal metal fixation is used to straighten it.
- In some cases, the joint is fixed by using tendons from other parts of the toe.
- By a process called Basal phalangectomy the base of the bone under the hammertoes is removed.
- At times, the metatarsal at the base of the toe is shortened. This process is termed the Weil osteotomy.
Don’t Let Hammertoes Bother You Anymore!
Here at Michigan Foot & Ankle Specialists, our team ensures the best care for all your foot and ankle problems, including hammertoes. If you have any queries, feel free to call us at 313-582-6222, or contact us online to schedule an appointment.
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