A Hammer toe can be flexible or rigid. Hammertoes often start out flexible and become rigid over time as your toe becomes accustomed to its crooked position. Flexible hammertoes are less serious than rigid hammertoes, as they can be easily diagnosed and treated in their initial stages. Flexible hammertoes are named as such because your affected toe still possesses some degree of movement.
Hammer toe may also be caused by other medical conditions such as rheumatoid arthritis, osteoarthritis, or stroke because these forms of illnesses involve affectation of the person's muscles and nerves. Diabetes is also a causative factor for hammer toes due to diabetic neuropathy, which often times accompanies advanced instances of diabetes. Injury to a person's toes may also cause hammer toes, particularly if the injury involves breaking of the toes. In some instances, hammer toes may be hereditary. Some people may be genetically predisposed to develop the condition because of the natural structure of their bodies.
Common reasons patients seek treatment for toe problems are toe pain on the knuckle. Thick toe calluses. Interference with walking/activities. Difficulty fitting shoes. Worsening toe deformity. Pain at the ball of the foot. Unsightly appearance. Toe deformities (contractures) come in varying degrees of severity, from slight to severe. The can be present in conjunction with a bunion, and develop onto a severe disfiguring foot deformity. Advanced cases, the toe can dislocate on top of the foot. Depending on your overall health, symptoms and severity of the hammer toe, the condition may be treated conservatively and/or with surgery.
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
What will a doctor do? Treat any foot complaints such as corns, calluses by periodically reducing the lesion and applying appropriate pads and dressings. Recommend the silicone toe prop. If an infection is present, then anti-septic dressings, antibiotics and pads to redistribute pressure away from the lesion may be necessary. In the case of a mallet toe, trigger toe or claw toe. If a corn occurs at the end of the toe, a silicone or leather hammertoe prop may be used to straighten the toe. In a hammertoe deformity, a silicone prop to redistribute pressure away from a corn may be necessary. The doctor may give footwear advice. In severe cases, corrective surgery may be necessary. The doctor may recommend orthosis to correct a mechanical complaint of the foot, such as 3/4 length silicone insoles.
Surgical correction is necessary in more severe cases and may consist of removing a bone spur (exostectomy) removing the enlarged bone and straightening the toe (arthroplasty), sometimes with internal fixation using a pin to realign the toe; shortening a long metatarsal bone (osteotomy) fusing the toe joint and then straightening the toe (arthrodesis) or simple tendon lengthening and capsule release in milder, flexible hammertoes (tenotomy and capsulotomy). The procedure chosen depends in part on how flexible the hammertoe is.