, Claw and Mallet Toe are similar conditions, all caused by deformity of the toe
joints. They usually develop slowly from wearing poor fitting shoes, but can also be due to muscle or nerve damage. Muscle imbalance causes the toes to bend into odd positions which can be extremely
painful, limiting walking and activity. They become more common with aging and affect approximately 10-15% of the population. Women are five times more likely to suffer from hammer, claw or mallet
toe than men.
Your toe contains two joints that allow it to bend at the middle and bottom. A hammertoe occurs when the middle joint becomes dislocated. Common causes of this joint dislocation include a toe injury,
arthritis, a high foot arch, wearing shoes that don?t fit properly, tightened ligaments or tendons in the foot, pressure from a bunion (when your big toe points inward toward your second toe) Spinal
cord or peripheral nerve damage may cause all of your toes to curl downward.
Hammer, claw, and mallet toes can cause discomfort and pain and may make it hard to walk. Shoes may rub on your toes, causing pain, blisters, calluses or corns, or sores. Sores can become infected
and lead to cellulitis or osteomyelitis, especially if you have diabetes or peripheral arterial disease. If you have one of these health problems and sores develop, contact your doctor.
The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear
crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at
the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still
flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the
involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.
Non Surgical Treatment
There are several treatment options. These are based on how severe the problem has become. The sooner a person seeks treatment, the more hammertoes
options that person may have. Wear properly fitting shoes; this does not necessarily mean expensive shoes. Padding any
prominent areas around the bony point of the toe may help to relieve pain. Medication that reduces inflammation can ease the pain and swelling. Sometimes a doctor will use cortisone injections to
relieve acute pain. A podiatrist may also custom-make an insert to wear inside your shoe. This can reduce pain and keep the hammer toe from getting worse. Your doctor may recommend foot exercises to
help restore muscle balance. Splinting the toe may help in the very early stages.
Sometimes surgery can not be avoided. If needed, the surgery chosen is decided by whether we are dealing with a flexible or rigid hammer toe. If the surgery is on a flexible hammer toe, it is
performed on soft tissue structures like the tendon and or capsule of the flexor hammer toe. Rigid hammer toes need bone surgeries into the joint of the toe to repair it. This bone surgery is called