Hammertoe

What is A Hammertoe

Hammertoe is contracture deformity of second, third, fourth or fifth toe. The contracture can occur at either of the 2 joints in the toe. The deformity usually starts out as a mild, flexible deformity but can progressively worsen overtime to a more rigid deformity. This contracture can then lead to contracture at the joint between the toe and the metatarsal located at the ball of the foot, which can result in subluxation/dislocation of the toe in severe cases.

Causes

The most common cause of a hammertoe is a muscle/tendon imbalance. This imbalance results from mechanical/structural or neurologic changes in the foot that occur over time.

Hammertoes can be aggravated by ill-fitting shoes. A hammertoe can also result from trauma while some people inherited the hammertoe.

Symptoms

Contracture of the toe
Pain or irritation of the affected toe
Corns and calluses
Inflammation, redness or burning sensation
Open wounds in severe cases
Pain under the ball of the foot

Diagnosis

A thorough physical examination of the foot is important in diagnosis especially to evaluate the severity of the hammertoe. X-rays and other advance imaging can be helpful in determining extend of the contracture.

Treatment

Non-surgical

Padding corns and calluses
Changes in shoegear
Orthotics
Medications
Steroid injection

Surgical

Usually reserved for more severe, rigid cases or in cases where a persistent corn/calluses or wound is present which has failed conservative treatment. Surgery involves reducing the fracture by removing some bone in the joint. Sometimes, a fusion of the joint/joints in the toes which are contracture can be done.