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Hammer Toe

 

What is a Hammer Toe?

The small toes can be pulled back on top of the foot by excessive pull of the toe tendons. This causes the joints to be prominent and shoes can cause painful pressure on the deformed toes. Sometimes this causes continually painful corns making walking very uncomfortable. Sometime the pressure can be extreme and cause ulcers on the toes.

Small toes can be displaced from their normal alignment because the Big Toe (hallux) is in a bunion position. This is known as hallux valgus. The Bunion can cause the toes deformities.

A hammer toe may develop because of

  • a deformity of the foot that is present at birth, causing tight tendons in the affected toe
  • a congenital misalignment of bones in the arch of the affected foot
  • failing to replace the shoes of children whose feet have outgrown them
  • high heels and other restrictive shoes
  • joint inflammation, such as that caused by arthritis
  • damage to the muscles and nerves of the foot from a long-term disease like diabetes
  • an injury

Hammer toe Surgery

Hammer toe Tendon Surgery
When the joints in the toe are still flexible is is possible to length the toe tendons holding the toe in the deformed position. This can include lengthening or the extensor tendon, repositioning the flexor tendon and rebalancing the small intrinsic toe tendons.

 

 

 

Hammer toe Joint Surgery


When the deformity has become rigid a small amount of bone is removed from the joint in order to allow the toe to straighten. This is called a surgical arthroplasty. The toe is flexible after the surgery.

When the deformity is severe bone may be removed from either side of the deformed joint, the toe is then fused in the corrected position. This is called an arthrodesis. Your Podiatric Surgeon will assess your foot and advised you which procedure is best for your type of toe deformity.

Hammer toe Skin Surgery
Pressure on the skin over a toe deformity can change it structure it may be a painful corn, or discolouration from your normal skin colour. A 'skin-plasty' can be performed to remove the skin lesion and damage. Their will be a scar line but this usually fades with time.

Some hammer toes cause the skin to contract. A ‘Z’ shaped skin incision is made to lengthen the skin over the area, allowing the toe to sit in a natural position, rather than a contracted postion.

Summary Treatment For Hammer toes

  • Nonsurgical treatment, such as debridement, padding, shoe modification, oral anti-inflammatory medication (NSAIDs), anti-inflammatory injectables, orthotics, orthodigital devices
  • Surgical treatments, such as
    • Tendon lengthening/tenotomy
    • Capsulotomy
    • Arthroplasty
    • Osteotomy or ostectomy
    • Exostosectomy
    • Arthrodesis
    • Diaphysectomy
    • Phalangectomy
    • Skin-plasty
  • Postoperative management, including x-rays, follow-up visits, weight bearing or immobilization, and orthotics