Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with changes in shoe styles and foot care products. But if left untreated, hammertoes can become more rigid and painful. Corns are more likely to develop as time goes on-and corns never really go away, even after trimming. In more severe cases of hammertoes, corn lesions may evolve into severe ulcerations. These lesions frequently occur in patients who have vascular disease or are Diabetic with neuropathy. The ulcerations can extend to the bone and result in infection and possible loss of digit or amputation.
Hammertoe commonly develops because of structural changes that take place over time in the muscles and tendons that bend the toes. People with certain medical conditions, such as diabetes, are at risk for developing hammertoe. It can be an inherited condition for some people. Other causes include trauma and wearing shoes that are too tight, narrow, or have high heels. The toe next to the big toe (second toe) is most frequently affected by hammertoe.
The symptoms of hammertoe include a curling toe, pain or discomfort in the toes and ball of the foot or the front of the leg, especially when toes are stretched downward. Thickening of the skin above or below the affected toe with the formation of corns or calluses. Difficulty finding shoes that fit well. In its early stages, hammertoe is not obvious. Frequently, hammertoe does not cause any symptoms except for the claw-like toe shape.
Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
A person with hammer toes will be asked to practice some exercises for their toes to regain average structure and movement. The exercises usually involve stretching and strengthening their toes. The person may attempt to pick things up off the floor using only their toes. They may also stretch their toes on a regular basis by hand to ease them into straightening out. Another example of a physical exercise specifically for a person’s toes involves crumpling a towel with the toes. The towel can lie underneath the person’s feet and the person can use their toes to scrunch up the towel as they perform simple tasks such as reading a book or watching television.
There are several surgical methods to correct a hammer toe. Your physician will decide which method will be most beneficial to you depending on the severity of your deformity, the direction the toe is deviating and the length of the affected toe. Some common surgical methods include. Arthroplasty. To promote straightening, half of the joint located directly underneath the crooked part of the toe is removed. Arthrodesis (fusion) To promote straightening, the joint directly underneath where the toe is crooked is completely removed. A wire or pin is inserted to aid healing. Tendon transfer. Performed alone or in combination with other procedures, a surgeon will take tendons from under the toe and ?re-route? them to the top of the toe to promote straightening. Basal phalangectomy. Performed to assist patients with severe stiffness, this procedure removes the base of the Hammer toes bone underneath the toe. Weil osteotomy. Performed to assist patients with severe stiffness, this procedure involves shortening the metatarsal bone and inserting surgical hardware to aid healing.