Uneven muscle tension results in the distortion of one or several of the small toes. (Hammer toe) Pressure points develop at the raised middle joint as well as at the tip of the toe and underneath the metatarsal head. In the beginning, when the misalignment can still be corrected, it often suffices to lengthen the tendon and to cut a notch into the capsule. In a contracted misalignment, part of the middle joint is removed to form a replacement joint. Modern surgical techniques preserve the metatarsophalangeal joint (Weil or Helal osteotomies).
Hammertoes are most common in women, and a big part of this is poor shoe choices, which are a big factor in the development of many foot problems. Tight toe boxes and high heels are the biggest culprits. Genetics certainly plays a role in some cases of hammertoes, as does trauma, infection, arthritis, and certain neurological and muscle disorders. But most cases of contracted toes are associated with various biomechanical abnormalities in how a patient walks. This causes the muscles and tendons to be used excessively or improperly, which deforms the toes over time.
If you have any of these symptoms, do not assume it is due to hammer toe. Talk to your doctor about symptoms such as a toe that curls down, corns on the top of a toe, calluses on the sole of the foot or bottom of the toe, pain in the middle joint hammertoe 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, difficult or painful motion of a toe joint, pain in the ball of the foot or at the base of a toe.
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
Mild hammer toe in children can be treated by manipulating and splinting the affected toe. The following changes in footwear may help relieve symptoms. Wear the right size shoes or shoes with wide toe boxes for comfort, and to avoid making hammer toe worse. Avoid high heels as much as possible. Wear soft insoles to relieve pressure on the toe. Protect the joint that is sticking out with corn pads or felt pads. A foot doctor can make foot devices called hammer toe regulators or straighteners for you, or you can buy them at the store. Exercises may be helpful. You can try gentle stretching exercises if the toe is not already in a fixed position. PIcking up a towel with your toes can help stretch and straighten the small muscles in the foot.
Treatment of a severe hammertoe that has become rigid includes surgery. What is done during the surgery depends on how misshapen and inflexible the toe is. The surgeon may make a cut over your toe and release the tendon by cutting the tendon away from the bone. The surgeon may remove a small piece of bone from the toe. The surgeon may realign the tendons to reposition your toe or fasten the bones with pins. Sometimes the surgeon may have to join the bones in the toe. In this case, you will no longer be able to bend the toe, but the toe will be flat.
Custom orthotics paired with a well made shoe can prevent the progression and development of hammertoes. Wearing proper-fitting shoes and custom orthotic devices can provide the support patients need to address muscle/tendon dysfunction. It can also support end stage diseases that result in hammertoe deformities by re-balancing the foot and ankle and controlling the deforming forces.