A hammer toe is a deformity in which the middle joint of a toe becomes bent causing the toe to curl under. Corns and calluses may be present on the top of the joint or tip of the toe due to pressure caused by the bent toe. Toe pain can develop and wearing shoes may be uncomfortable as it rubs the skin over the deformity.
A hammer toe is usually caused by a combination of muscle imbalance and not wearing proper fitting shoes. When a toe is held in a bent position due to tight or narrow shoes, the muscles tighten and cannot stretch out. After a period of time with the foot in this position, the toe is unable to straighten even when it is not constrained. Initially, hammer toes are flexible and you can straighten the toe with your finger. If left untreated, this may develop into a rigid or fixed toe that cannot be moved with manipulation.
Mild symptoms may be treated with changing shoe wear and toe pads or other cushioning device. Comfortable shoes that are not too narrow are important. Exercises to help stretch and strengthen foot muscles can help as well. If your symptoms are severe, surgery may be recommended. Surgery is done as an outpatient procedure, meaning you go home the same day. The type of procedure depends on hammer toe severity and if the joint is flexible or rigid. For flexible hammer toes, a tendon release can be performed. The surgeon will make a small incision on the toe and cut the tendon, allowing it to heal in a lengthened position. For rigid hammer toes, damaged skin and a piece of bone may need to be removed to help straighten the digit. Sometimes, a joint fusion is necessary. During this surgery, the joint cartilage is removed and a metal pin is used to hold the bones together as they heal into one, straight bone. It is important to discuss surgical risks and treatment options with your physician.