What are Hammertoes?
An imbalance between the tendons located on the top and bottom of your toe can cause a contracture of the toes, a condition known as hammertoes. Hammertoes can be flexible or rigid. When rigid, they make it impossible to straighten your toe out by manipulating it.
Hammertoes can cause you to develop corns on the top of your toe from constant rubbing against your shoe. They may also cause the ball of your foot to develop a bothersome callous from your toe pressing downward on the bone behind the toe (see Corns and Calluses). Over time, hammertoes can become worse, and flexible deformities often become rigid (for information on hammertoe of the big toe, see Hallux hammertoe).
Treatment of hammertoes can be preventive or can address the symptoms. In some cases, surgery may be necessary to cure the condition.
Preventive Hammertoe Treatment
For preventive treatment, steps can be taken to address the cause of the deformity. Better shoes with a thicker, stiffer sole and good arch support can be helpful. Functional orthotics, special shoe inserts prescribed by your podiatrist, are sometimes needed to address the abnormal functioning of the foot that causes hammertoes. These functional orthotics can slow the natural, gradual changes in the foot that can lead to a variety of foot problems.
Flexible hammertoes may often improve over time by the use of orthotics. Your podiatrist may also suggest calf exercises to help overcome part of the muscle imbalance that causes hammertoes to form.
Treatment for Hammertoe Symptoms
Conservative treatment for your individual hammertoe symptoms can include open-toed shoes, shoes with a taller toebox or hammertoe pads. Over-the-counter corn removers, although not recommended by our doctors, can help reduce the callouses associated with hammertoe. If you do try these medications, use caution. These medications are not to be used for callouses between the toes, or by persons with diabetes or poor circulation.
Treatment for Curing Hammertoe
Treatments to address the hammertoe deformity vary depending on the severity of the condition. Flexible hammertoes can sometimes be addressed by a simple tendon release in the toe. Recovery is usually quick and requires only a single and a bandage, or no stitch at all. If you have several toes treated at the same time, the recovery can take a bit longer.
Surgical correction of rigid or semirigid hammertoes may require removing a small section of bone at the level of the rigid joint and placing a temporary pin across the toe to maintain alignment. Sutures are place and will remain in place for approximately ten days. Most surgeons will ask that you leave the bandage in place until your follow-up visit, so you shouldn’t need to change the bandages at home. It’s important to stay off your feet as much as possible during this time to prevent excessive swelling of your toe. This surgical procedure requires several weeks of recovery.
If pinning the toe is not required, the surgery can sometimes be performed in your doctor’s office under local anesthesia. If a pin must be placed, or if you prefer the comfort of sedation during surgery, then the surgery can be performed in an outpatient surgery center.
Risks and Complications of Hammertoe Surgery
Any surgical procedure comes with risks and complications, and hammertoe surgery is no exception. Possible complications associated with hammertoe surgery include infection, excessive swelling, and potential deviation of the toe. Excessive swelling can lead to delays in your healing process. If bone is removed during the surgery, your toe may be a bit floppy for several weeks following surgery. This is normal and generally not a permanent condition.