There may be many causes of hammer toes. Austin Ankle Associates individualizes the surgery needed to correct hammer toes based on each patient’s unique, underlying causes.
The term hammer toe refers to an angular deformity involving the lesser (2-5) toes. There is a wide range of severity and presentations of hammer toes. The toe is usually bent at one of the small joints in the toe causing a prominence at the top or dorsal side of the foot. The toes can also be deviated medially or laterally and can be flexible or rigid. The causes of hammer toes are multifactorial but generally are due to muscle imbalances. Much like bunions, hereditary factors, tight fitting shoe wear, neurologic pathology, tight calf muscles, and other systemic diseases can contribute to their formation.
Pain from a hammer toe is usually related to pressure inside shoe wear caused by the prominences created by the angular deformity either on the top (dorsal) side of the toe, the tip of the toe, or pressure on adjacent toes. Callouses in these areas are common. The other main source of pain is caused by pressure on the bottom or plantar aspect of the foot in the area of the metatarsal heads. This is the area commonly referred to as the “ball” of the foot. As the deformity progresses and the toe extends upward, the metatarsal head bears more weight when walking and can become painful. This pain can also be related to having excessively long metatarsals.
Conservative treatment consists of shoe wear modifications with larger more accommodative shoes which allow more room for the deformities, toe splints, cushions, pads, orthotic insoles, anti-inflammatory medications, and calf stretching. When these measures fail to provide relief of symptoms, surgery is often considered to permanently straighten, balance, and re-align the deformities of the toes. There are many different techniques and combinations of procedures to correct hammer toes based on the pathology which is causing the deformity. Austin Ankle Associates individualizes the surgical interventions needed to correct hammer toes based on each patient’s underlying causes.