When one or more of the smaller toes curls under the foot, instead of lying straight, the condition is called Hammertoe. The downward turning toe resembles a hammer, giving the condition its name. The cause is a weakened muscle in the footthat creates an imbalance with the surrounding muscles. The stress then shortens the tendons, as they try to compensate, and pulls the toe or toes down. Hammertoes can be genetic, but most often wearing shoes that are too short, too tight, or put unnatural pressure on the ball of the foot is the cause. Hammertoes begin as a mild curl but, without intervention, the curl becomes a deeper buckle of the toe joints, until stress on the tendon makes the toe or toes become rigid.
As the condition progresses, the whole foot and then the legs and back can become impacted. As the toe bends, it begins to rub against the shoe, causing corns, blisters and irritation that make wearing shoes and walking uncomfortable. Walking in a way to avoid the pain begins to throw off the posture, which over time undermines the body’s structure, causing chronic pain in the legs, hips and the back.Balance becomes undermined, leaving you more prone to falls. Treating hammertoes is essential to healing the rest of the body.
Our Non-Surgical Treatments to Slow or Stop the Progress of Hammertoes
When the condition is in its early stages, the toes are still flexible. They can bend and don’t protrude enough to begin to rub against the shoe. Peripheral muscles and tendons in the foot have not yet been impacted. Our experts will help you implement non-surgical measures that can be taken to slow or stop the progression.
- A change in footwear is necessary in all cases.Avoiding shoes that are too tight or too short, and high heels that put too much pressure on the ball of the foot is a necessary first step. Instead, wearing shoes with a deep, roomy toe box and heels no higher than two inches slows or even stops the progression.
- Custom made orthotic devices that control the muscle and tendon imbalance and properly realign the foot can be a solution.
- Realigning the toe or toes using splinting and straps could be recommended.
- Pain relievers and cortisol injections may be prescribed to deal with the pain.
- Healing peripheral problems, like corns and callouses, by trimming, toe splinting or padding could be a necessary part of the treatment.
Surgery
When the toe or toes become too rigid, causing pain when walking and keeping you from living a healthy lifestyle, surgery may be needed. At that point, many parts of your amazingly complex feet – the muscles, bones, joints, ligaments and tendons – have been impacted, too, and might need to be treated surgically, as well.
Depending upon the complexity of your condition, we offer several surgical options to remedy hammertoe, each with its own unique benefits dependent on the nature of your condition. Straightening the toes involves cutting the bone, tendon, joints and/or ligaments.
Keep in mind that all procedures are carried out with your physical and emotional comfort and safety in mind. Very soon you will be back to living the lifestyle you’ve been missing.
- TENOTOMY and CAPSULOTOMY: These terms refer to the cutting of tendons and joint capsules. More specifically in relation to hammertoe deformities, the tight tendons and joint capsules located on the top and bottom of the buckled or contracted toe joints are released. Once these tight, soft-tissue structures are cut and relaxed, the toe can resume its normal flattened posture.
- ARTHROPLASTY: This very popular procedure for a pediatric podiatrist involves removal of cartilage and bone in remodeling a deformed joint. It allows for relief of the painful area.
- ARTHROPLASTY WITH FIXATION FOR FUSION:This procedure involves joint removal and the use of a wire (pin) to stabilize or fuse the deformed toe.
- ARTHROPLASTY WITH TENDON RELOCATION: Realigning the toe by relocating the flexor tendon pulls the toe down and creates a joint space.
- ARTHROPLASTY WITH IMPLANTATION: Following excision of a joint, a plastic implant is placed inside to act as a functional spacer.
- DEROTATION/REALIGNMENT PROCEDURE FOR OVERLAPPING TOE:A wedge of skin and a segment of bone are removed to realign the overlapping toe.
- BONE SPUR REMOVAL:An incision is made and an instrument is used to file or excise the bone spur and remove the source of increased pressure.
- OSTEOTOMY:A cut is made through the bone to allow it to be realigned. Wire or pin fixation could be required.
POST OPERATIVE FOOT CARE:
After cosmetic foot surgery from one of our foot specialists, you will receive instructions regarding the care of your dressings, your level of activity and weight-bearing ability. As with all foot surgery, rest and elevation can help reduce pain and swelling. Our caring doctors will monitor you through your healing process. We promise to get you back on your feet again in no time.