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Hammertoe Deformity
Hammertoe is a contracture or bending of one or both joints of the second, third, fourth, or fifth toes.
Symptoms
- Pain or irritation of the affected toe when wearing shoes
- Corns - A buildup of skin on the top, side, or end of the toe, or between the toes
- Calluses - Another type of skin buildup on the bottom of the toe or on the ball of the foot
Because of the progressive nature of hammertoes, they should receive early attention. Hammertoes never get better without some kind of intervention.
Causes
- Muscle/Tendon imbalance is the most common cause of a hammertoe
- Hammertoes are often aggravated by shoes that don't fit properly
- Hammertoe may be caused by some kind of trauma, such as a previously broken toe
- Can be inherited
Diagnosis
In diagnosing Achilles tendonitis or tendonosis, an examination of the foot and ankle including evaluating the range of motion and condition of the tendon. The extent of the condition can be further assessed with x-rays, ultrasound or MRI.
Treatment
Non-Surgical Approaches:
- Trimming corns & calluses - This should be done by a healthcare professional
- Padding corns & calluses - Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful
- Changes in shoewear
- Orthotic devices
- Injection therapy
- Oral medication [Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)]
- Splinting/Strapping
When Is Surgery Needed?
In some cases, usually when the hammertoe has become more rigid or conservative therapy has failed, surgery is needed to relieve the pain and discomfort caused by the deformity.
The most common surgical procedure performed to correct a hammertoe is called arthroplasty. In this procedure, the surgeon removes a small section of the bone from the affected joint.
Another surgical option is arthrodesis, ( fusing of a joint) which is usually reserved for more rigid toes or severe case. A pin or other small fixation device is typically used to hold the toe in position while the bones are healing.
Some other procedures that might be needed depending on the severity of the toe include skin wedging, tendon/muscle rebalancing or lengthening, small tendon transfers, or relocation of surrounding joints.
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