What is a Hammertoe?
A hammertoe is a foot deformity typically found in the lower digits of the foot. In this condition, the toe is bent at the middle joint, making it look like a hammer. Hammertoes can also lead to other foot conditions such as bunions, corns, or calluses. Foot pain and discomfort are not normal conditions with which you should have to live. We are proud to offer in-office hammertoe treatment to our patients.
There are two types of hammertoes:
Hammertoes can be similar to other foot deformities such as claw toe or mallet toes.
Symptoms of the hammertoe condition may include:
Hammertoes are often the result of a muscle imbalance or due to constant improper footwear, but they can also be caused by a combination of factors. Other factors may include genetics, trauma to the toe, and conditions such as arthritis or diabetes.
Treatment varies depending on the type of hammertoe and condition of the patient. After a thorough examination, your podiatrist will recommend the appropriate line of treatment for you.
Conservative treatment for hammertoes may include lifestyle changes such as a change in footwear. Pick shoes that have deep shoe boxes that are half an inch longer than your longest toe. Avoid wearing tight, narrow, or high heeled shoes. Your podiatrist may also recommend toe exercises to help strengthen the muscles. Straps, pads, and cushions can be bought at local stores to help relieve pressure and discomfort while wearing shoes.
If you have diabetes, poor circulation, or nerve damage, talk to your doctor before considering self-treatment or home remedies.
Surgery should not be the first treatment option for hammertoes. Mild to moderate cases are typically manageable with lifestyle changes such as changing shoes, using inserts, or padding. If these methods do not relieve your pain or symptoms, surgery may be the right option for you.
If you have multiple foot conditions that are commonly associated with hammertoes such as bunions, heel spurs, or corns, your doctor may recommend treating them in a single operation.
Hammertoe surgery is typically an outpatient procedure, meaning you can return home following surgery. Patients can choose to have general or local anesthesia during the procedure to avoid any discomfort or pain.
The type of surgery you have will depend on the severity of your condition and whether you have a flexible or fixed hammertoe.
Tendon Transfer Surgery – If your toe is flexible and can be easily straightened during your examination, your doctor may elect to perform a tendon transfer. During this procedure, tendons are rerouted from the bottom of your toe to straighten the joint. Occasionally, the base of the toe will also need to be released to allow your toe to lay completely straight.
Joint Resection Surgery – If your toe is fixed, your doctor may remove the rigid joint to treat the hammertoe. In this procedure an incision is made to allow for easy access to the tendons and ligaments, they are then cut to allow for straightening. The end of the bone at the fixed joint is removed as well to allow for complete straightening. Pins are often used to help the toe heal properly during the first month of recovery.
Fusion Surgery – Fusion surgery is another option for hammertoes that are fixed and unable to be straightened during an examination. During this procedure ligaments and tendons are also cut to straighten the toe, however the ends of the several bones within your toe may be cut to allow the toe to straighten. Small metal pins, screws, and other implants may be used while the bones heal together.
Full recovery will vary depending on the type of surgery that was performed on your toe. Patients may be prescribed a special shoe or boot, crutches, or a walker to help walk and maintain balance during recovery.
Though this is an outpatient procedure, you should avoid standing, driving, or walking around during recovery. Consider arranging for a family member, friend, or caregiver to help you around the house or with errands during the first few weeks of recovery. Rearranging your house before surgery is another good tip so that you can be at ease during recovery and have everything you need close by.
Patients will be advised to keep their foot elevated during the first few weeks of recovery to reduce swelling and pressure off of the toe. You may also be asked to exercise or stretch your toe at home to help with flexibility and motion.
Risks and Complications
All surgeries come with the possibility of complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, or bleeding and blood clots.
Though rare, it is possible that your hammertoe may return after surgery or that your toe may feel “unstable”. The instability is due to the cutting of ligaments and tendons, but the feeling should subside throughout recovery. If your hammertoe returns, a second surgery may be recommended. Another complication of hammertoe surgery is that some patients report a loss of mobility or function of the toe, but this should not affect your ability to walk or maintain balance.
For more information on hammertoes and the treatment options available to you, please contact Adam F. Resnikoff, DPM today.