Hammertoe is a deformed toe that develops when the tendons and ligaments that support the toe become shortened and stiff. Any toe except the big toe can develop the condition, which causes the toe to assume a bent, claw-like appearance over time. Because of their bent shape, the skin on the top of the joint often rubs against shoes, causing painful blisters and calluses to form.
The main cause of hammertoes is long-term wear of shoes that don't fit properly. When toes are crowded, over time the tendons and ligaments can become tighter, pulling the top of the toe downward until it assumes its bent appearance. Initially, these toes may remain flexible, but without care, they can become stiff, and treatment becomes more complex. Hammertoes often tend to occur more commonly among people with nerve diseases or circulation problems, and people with some types of inherited foot shapes are also more likely to develop hammertoes.
Sometimes, hammertoes can be corrected by switching to shoes that fit properly and offer more room in the toe area of the shoe, as well as avoiding high heels which force the toes into a cramped, bent position. Once the toe joint begins to stiffen, custom-made orthotics may be used to support the toe in its proper shape and to coax the ligaments and tendons to become more flexible. Gentle stretching exercises also can be used to enable the ligaments and tendons to resume their normal positions over time. Splints may also be used, especially when sleeping, to help the toe “hold” a normal position. In some more advanced cases or when conservative approaches fail to keep the toe in a normal position, hammertoe surgery may be needed to reposition the joint as well as the tendons and ligaments that are causing the toe to bend. During hammertoe surgery, a small section of bone is removed to allow the toe to find its proper position and shape.
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