Hammer Toe

The most common cause of hammer toe is wearing short, narrow shoes that are too tight. The toe is forced into a bent position. Muscles and tendons in the toe tighten and become shorter.

Hammer toe is more likely to occur in:

• Women who wear shoes that do not fit well or have high heels
• Children who keep wearing shoes they have outgrown

The condition may be present at birth (congenital) or develop over time.

In rare cases, all of the toes are affected. This may be caused by a problem with the nerves or spinal cord.

Symptoms

The middle joint of the toe is bent. The end part of the toe bends down into a claw-like deformity. At first, you may be able to move and straighten the toe. Over time, you will no longer be able to move the toe. It will be painful.

A corn often forms on the top of the toe. A callus is found on the sole of the foot.

Walking or wearing shoes can be painful.

Signs and tests

A physical examination of the foot confirms that you have hammer toe. The health care provider may find decreased and painful movement in the toes.

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.

For severe hammer toe, you will need an operation to straighten the joint. Lehigh Valley Orthopedic Institute has orthopedic surgeons who specialize in the treatment of hammer toe.

• The surgery often involves cutting or moving tendons and ligaments.
• Sometimes the bones on each side of the joint need to be connected (fused) together.

Most of the time, you will go home on the same day as the surgery. The toe may still be stiff afterward, and it may be shorter.

Expectations (prognosis)

If the condition is treated early, you can often avoid surgery. Treatment will reduce pain and walking difficulty.