Hammer/Mallet Toe

Symtoms

Pain occurs upon pressure at the top of the bent toe from footwear.

The formation of corns on the top of the joint can be a strong piece of evidence that the toes are no longer aligned properly. Corns come from the friction of the toe against the top of the shoe.

Redness and swelling at the joint contracture.

The joint can be painful or not as flexible as usual, and pain in the ball of the foot at the base of the affected toe can occur.

Hammer toes are more common in females than they are in males (because of footwear).

Possible Causes

A hammertoe is a contracture or bending of the toe at the fIrst joint of the digit, called the proximal interphalangeal joint. This bending causes the toe to appear like an upside-down when looked at from the side. Any toe can be involved, but the condition usually affects the second through fifth toes, known as the lesser digits.

A hammertoe is formed due an abnormal balance of the muscles in the toes. This abnormal balance causes increased pressures on the tendons and joints of the toe, leading to its contracture. Heredity and trauma can also lead to the formation of a hammertoe. Arthritis is another factor, because the balance around the toe in people with arthritis is so disrupted that a hammertoe may develop. Wearing shoes that are too tight and cause the toes to squeeze can also be a cause for a hammertoe to form.

See claw toe.

Treament

Apply a commercial, nonmedicated hammertoe pad around the bony prominence of the hammertoe. This will decrease pressure on the area. Wear a shoe with a deep toe box. If the hammertoe becomes inflamed and painful, apply ice packs several times a day to reduce swelling, and take anti-inflammatory medication.

Avoid heels more than two inches tall. A loose-fitting pair of shoes can also help protect the foot while reducing pressure on the affected toe, making walking a little easier until a visit to your podiatrist can be arranged. It is important to remember that, while this treatment will make the hammertoe feel better, it does not cure the condition. A trip to the podiatric physician's office will be necessarv to repair the toe to allow for normal foot function. Children should have their shoes properly fitted on a regular basis, as their feet can often outgrow their shoes rapidly. See your podiatric physician if pain persists.

The treatment options vary with the type and severity of each hammer-toe, although identifying the deformity early in its development is important to avoid surgery. Podiatric medical attention should be sought at the first indication of pain and discomfort because, if left untreated, hammertoes tend to become rigid, making a nonsurgical treatment less of an option.