Hammer, claw, and mallet toes are toes that do not have the right shape. They may look odd or may hurt, or both. Tight shoes are the most common cause of these toe problems. A hammertoes
is a toe that bends down toward the floor at the middle toe joint. It usually happens in the second toe. This causes the middle toe
joint to rise up. Hammer toes often occur with bunions. Claw toe often happens in the four smaller toes at the same time. The toes bend up at the joints where the toes and the foot meet. They bend
down at both the middle joints and at the joints nearest the tip of the toes. This causes the toes to curl down toward the floor. A mallet toe often happens to the second toe, but it may happen in
the other toes as well. The toe bends down at the joint closest to the tip of the toe.
Hereditary and shoe gear are probably the most likely reasons to develop a hammer toe. Tight pointy shoes may cause a hammer toes. High heels also can cause hammer toes. A deformed toe often develops
over time, and certain types of feet may be predisposed. Some patients may develop a hammer toe or cross over toe (of the 2nd toe) due to a bunion of the big toe.
A hammertoe may be present but not always painful unless irritated by shoes. One may have enlarged toe joints with some thickened skin and no redness or swelling. However, if shoes create pressure on
the joint, the pain will usually range from pinching and squeezing to sharp and burning. In long standing conditions, the dislocated joints can cause the pain of arthritis.
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some
types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe. If the deformed toe is very painful, your doctor may recommend that you have a fluid sample withdrawn
from the joint with a needle so the fluid can be checked for signs of infection or gout (arthritis from crystal deposits).
Non Surgical Treatment
Padding and Taping. Often this is the first step in a treatment plan. Padding the hammertoe prominence minimizes pain and allows the patient to continue a normal, active life. Taping may change the
imbalance around the toes and thus relieve the stress and pain. Medication. Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the joint
deformity. Orthotic Devices. Custom shoe inserts made by your podiatrist may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the hammertoe
Surgical correction is needed to bring the toe into a corrected position and increase its function. Correction of the hammer toes is a simple outpatient surgery, with limited downtime. The best
option is to fuse the deformed and contracted toe into a straight position. This limits the need for future surgery and deformity return. A new pin that absorbs in the bone or small screw is used by
the Foot and Ankle Institute to avoid the need for a metal pin protruding from the toe during recovery. Although the absorbable pin is not for everyone, it is much more comfortable than the pin
protruding from the end of the toe. In certain Hammer toes
cases, a removal of a small area of bone
in the deformity area will decrease pain and limit the need for a surgical waiting period that is found with fusions. Although the toe is not as stable as with a fusion, in certain cases, an
arthroplasty is the best option.
Early Development. The first year of life is important for foot development. Parents should cover their babies' feet loosely, allowing plenty of opportunity for kicking and exercise. Change the
child's position frequently. Children generally start to walk at 10 - 18 months. They should not be forced to start walking early. Wearing just socks or going barefoot indoors helps the foot develop
normally and strongly and allows the toes to grasp. Going barefoot outside, however, increases the risk for injury and other conditions, such as plantar warts. Children should wear shoes that are
light and flexible, and since their feet tend to perspire, their shoes should be made of materials that breathe. Replace footwear every few months as the child's feet grow. Footwear should never be
handed down. Protect children's feet if they participate in high-impact sports.