is a Z-shaped deformity caused by dorsal subluxation at the
metatarsophalangeal joint. Diagnosis is clinical. Treatment is modification of footwear and/or orthotics. The usual cause is misalignment of the joint surfaces due to a genetic predisposition toward
aberrant foot biomechanics and tendon contractures. RA and neurologic disorders such as Charcot-Marie-Tooth disease are other causes.
Hammertoes are a contracture of the toes as a result of a muscle imbalance between the tendons on the top of the toes (extensor tendons) and the tendons on the bottom of the toes (flexor tendons). If
there is an imbalance in the foot muscles that stabilize the toe, the smaller muscles can be overpowered by the larger flexor and extensor muscles.
A hammertoe may be present but not always painful unless irritated by shoes. One may have enlarged toe joints with some thickened skin and no redness or swelling. However, if shoes create pressure on
the joint, the pain will usually range from pinching and squeezing to sharp and burning. In long standing conditions, the dislocated joints can cause the pain of arthritis.
Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your
foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
Symptomatic treatment of hammertoes consists of such things as open toed shoes or hammertoe pads. There are over the counter corn removers for temporally reducing the painful callous often seen with
the hammertoe. These medications must be used with caution. They are a mild acid that burns the callous off. These medications should never be used for corns or callouses between the toes. Persons
with diabetes or bad circulation should never use these products.
If conservative treatments fail and your symptoms persist, the doctor may recommend a surgical option to straighten the toe. The procedures used vary greatly, depending upon the reasons for the
hammertoe. There are a number of different operations to correct hammertoes, the most common ones involve Soft tissue corrections such as tendon transfers, tendon lengthening, and joint capsule
repairs. Digital arthroplasty involves removal of bone from the bent joint to allow the toe to straighten. The temporary use of pins or K-wires may be necessary to keep the toe straight during the
healing period. Joint implants are sometimes used to allow for a better range of motion in the toe following surgery. Digital arthrodesis involves the removal of bone from hammertoe
the bent joint and fusing the toe in a straight position. If the corn is due to a bone spur, the most common
procedure used is an exostectomy, in which surgically removing it or filing it down removes the bone spur. Because of the possible complications involved with any surgery, one should be sure to
understand the risks that may be involved with surgery to correct hammertoes and remove bone spurs.