Hammertoes are quite common and may range from mild to severe. A Hammertoe is a contracture, or bending, of one or more toes, usually due to an imbalance between the muscles or tendons on the top and bottom of the toes. Over time, the affected toes lose flexibility, becoming rigid and fixed in a contracted position. The abnormal bend positions the knuckle of the toe upward, causing it to push against the top of the shoe leading to additional problems. The condition usually becomes progressively worse if not treated.
Some causes of hammertoe are shoes that are too tight or short, shoes with high heels, injury, Diseases that affect the nerves and muscles, such as arthritis and diabetes. When shoes do not fit well, over time the pressure of the shoes pushes the toes into a bent position. After a while, the muscles become unable to straighten the toe, even when you are not wearing shoes. Similarly, when there is damage or disease of the nerves or muscles in the toes, the toe may rest in the bent position until the tendons become permanently shortened and the toe becomes a rigid hammertoe. The risk of developing a hammertoe increases with age. Women are much more likely to develop a hammertoe than men.
Symptoms may include pain in the affected toe or toes when you wear shoes, making it hard or painful to walk. A corn or callus on the top of the joint caused by rubbing against the shoe. Swelling and redness of the skin over the joint. Trouble finding comfortable shoes.
Your doctor is very likely to be able to diagnose your hammertoe simply by examining your foot. Even before that, he or she will probably ask about your family and personal medical history and evaluate your gait as you walk and the types of shoes you wear. You'll be asked about your symptoms, when they started and when they occur. You may also be asked to flex your toe so that your doctor can get an idea of your range of motion. He or she may order x-rays in order to better define your deformity.
Non Surgical Treatment
In many cases, conservative treatment consisting of physical therapy and new shoes with soft, spacious toe boxes is enough to resolve the condition, while in more severe or longstanding cases podiatric surgery may be necessary to correct the deformity. The patient's doctor may also prescribe some toe exercises that can be done at home to stretch and strengthen the muscles. For example, the individual can gently stretch the toes manually, or use the toes to pick things up off the floor. While watching television or reading, one can put a towel flat under the feet and use the toes to crumple it. The doctor can also prescribe a brace that pushes down on the toes to force them to stretch out their muscles.
Ordinary hammertoe procedures often use exposed wires which extend outside the end of toes for 4-6 weeks. Common problems associated with wires include infection where the wires come out of the toe, breakage, pain from hitting the wire, and lack of rotational stability causing the toe to look crooked. In addition, wires require a second in-office procedure to remove them, which can cause a lot of anxiety for many patients. Once inserted, implants remain within the bone, correcting the pain and deformity of hammertoes while eliminating many of the complications specific traditional treatments.