Hammertoe is a condition that typically occurs in one of the middle three toes, but can occasionally be seen in the little toe as well. It is when the toe experiences pressure or trauma that causes it to bend at one of the first two joints for long periods of time. Eventually this joint (the proximal interphalangeal joint, or PIP) becomes fixed in this position and the result is a hammertoe. If it is addressed early on the joint will most like still be fairly supple and treatment is much easier. If left untreated, however, the joint becomes a fixed deformity and requires surgical intervention to repair.
Hammertoe is often the result of an imbalance in the muscles and tendons that flex and extend the toe. If a person frequently wears restrictive shoes, the toes can be forced into a shortened position that will cause the muscles and tendons to shorten and tighten over time. The bent position that you are left with is known as a contracture deformity.
Hammertoe can come with a variety of symptoms. Symptoms are usually mild but can grow to be fairly severe in extreme cases. Some common symptoms of hammertoe are:
- Pain or irritation of the PIP joint
- Calluses on top of or between the effected toes
- Swelling of the joint
- Sores or redness on top of effected toe from contact with shoe
- Extreme bending or cramping of the toe
- Pain or difficulty with walking
A hammertoe is easily diagnosed with a physical examination. The doctor will ask about your symptoms and how long they have been going on and might do a minor test to assess how much flexibility remains in the joint. In a more extreme case, the doctor might schedule an x-ray to get a better idea of how much damage has occurred.
Nonsurgical Treatment for Hammertoe
Before opting for surgery your doctor will likely recommend a few non-invasive remedies to try at home. Hammertoes are progressive, meaning that if nothing is done, they will only get worse, but treatment is usually fairly simple. Some at home remedies you can try are:
- Change in footwear, look for shoes that have a more open toe box and put less pressure on the toes when walking
- Exercises to strengthen the muscles in the toes and feet like picking things up off the ground with your toes
- Orthopedic devices/inserts to help address the muscular imbalance
- Splints or straps to help stretch out the toe and maintain proper alignment
Surgery for Hammertoe
If it is decided that surgery is needed there are a few options that your doctor will discuss with you to determine which is the best fit for your personal condition. The three main types of surgery performed on hammertoes are tendon lengthening surgery, tendon transfer surgery (where a tendon from the bottom of the toe is transferred to the top), or joint fusion surgery
(arthrodesis) where a portion of the bone is removed, and the toe is held in a straight position with a metal pin or plate. Joint fusion surgery is only necessary in patients with extremely rigid or fixed hammertoes.
Recovery after a surgery like the ones mentioned above is fairly quick, generally taking only a month or so to get back to normal, and you will likely be able to walk on the treated foot immediately after the procedure. It is recommended that you limit your activity and rest as often as possible post-op in order to speed up the healing process. Listen to your doctor’s instructions and keep them informed on any changes or concerning symptoms that might arise after your procedure. It is also worthwhile to mention that the toe that received treatment might turn out to be slightly longer or shorter than it was before. This is a harmless result of the surgery and should come with no noticeable side effects.
If you have questions concerning your own symptoms or think you might need treatment on your own hammertoe, please reach out to Dr. Inglima and call tour office to schedule a diagnostic appointment.