• Hammer Toe

    (Hammertoe)

    Definition

    A hammer toe is a toe that tends to remain bent at the middle joint in a claw-like position. This is can be very painful. There are two types of hammer toe.
    A flexible hammer toe has the ability to be straightened manually.
    A rigid hammer toe cannot be pulled straight and can be extremely painful. After time, the top of the toe may press up against the shoe. This may cause corns or calluses (thickened skin). These are also painful.
    The sooner a hammer toe is treated, the better the outcome. If you suspect you have this condition, contact your doctor.
    Hammertoe
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    Causes

    Hammer toe may be congenital (present at birth) or develop later. It occurs when there is a dislocation of the middle joint of the toe due to:
    • Ligaments or tendons that have tightened, causing the toe's joints to curl downward
    • Pressure from a nearby bunion
    • Wearing inappropriate footwear:
      • Shoes that don't fit properly, for either an adult or child
      • High heels
      • Narrow-toed shoes
    • Arthritis
    • The foot having a high arch
    • Injury to a toe
    Occasionally, all toes may be bent. This may be due to problems with the peripheral nerves or the spinal cord.

    Risk Factors

    Factors that increase your chance of getting hammer toe include:
    • Family history of hammer toe
    • Arthritis
    • Bunions
    • Foot and ankle abnormalities
    • Frequent use of the inappropriate footwear (listed above)

    Symptoms

    If you have any of these symptoms, do not assume it is due to hammer toe. These symptoms may be caused by other, less serious health conditions. If you experience any one of them, see your physician.
    • A toe that buckles under
    • Corns on the top of a toe
    • Calluses on the sole of the foot or bottom of the toe
    • Pain in the middle joint of a toe
    • Discomfort on the top of a toe
    • Difficulty finding any shoes that fit comfortably
    • Cramping in a toe, and sometimes also the foot and leg
    • Infections or ulcers in a toe
    • Redness or swelling at a toe joint
    • Difficult or painful motion of a toe joint
    • Pain in the ball of the foot or at the base of a toe

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam of the toe will be done.

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include the following:

    Conservative Treatments

    • Splinting the affected toe
    • Switching to properly sized footwear with roomy toe boxes
    • Splints, straps, cushions, or corn pads to relieve symptoms
    • Applying an appropriate moisturizing cream to keep the skin soft

    Corrective Surgery

    Severe cases require an operation to straighten the joint.
    • Tendons may be cut or transferred.
    • The middle joint of the toe may be fused together.
    If you are diagnosed with hammer toe, follow your doctor's instructions .
    If you are diagnosed with hammer toe, follow your doctor's instructions .

    Prevention

    To help reduce your chances of getting hammer toe, take the following steps:
    • Avoid wearing poorly fitting or narrow-toed shoes.
    • Avoid heels higher than two inches.
    • Check your child’s shoe size often.

    RESOURCES

    American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/

    American Podiatric Medical Association http://www.apma.org

    CANADIAN RESOURCES

    Health Canada http://www.hc-sc.gc.ca

    Nurses Entrepreneurial Foot Care Association of Canada http://www.nefca.ca/

    References

    Hammer toe. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00160 . Updated September 2012. Accessed January 7, 2013.

    Hammer toes. American Podiatric Medical Association website. Available at: http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=1863 . Accessed January 7, 2013.

    Hammer toe. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated May 25, 2010. Accessed January 7, 2013.

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