hammertoes, Claw and Mallet Toe are similar conditions, all caused by deformity of the toe joints. They usually develop slowly from wearing poor fitting shoes, but can also be due to muscle or nerve damage. Muscle imbalance causes the toes to bend into odd positions which can be extremely painful, limiting walking and activity. They become more common with aging and affect approximately 10-15% of the population. Women are five times more likely to suffer from hammer, claw or mallet toe than men.
Hammer toe results from shoes that don't fit properly or a muscle imbalance, usually in combination with one or more other factors. Muscles work in pairs to straighten and bend the toes. If the toe is bent and held in one position long enough, the muscles tighten and cannot stretch out. Shoes that narrow toward the toe may make your forefoot look smaller. But they also push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of corns and calluses, which further aggravate the condition. A higher heel forces the foot down and squishes the toes against the shoe, increasing the pressure and the bend in the toe. Eventually, the toe muscles become unable to straighten the toe, even when there is no confining shoe.
Hammertoe and mallet toe feature an abnormal hammertoe bend in the joints of one or more of your toes. Moving the affected toe may be difficult or painful. Corns and calluses can result from the toe rubbing against the inside of your shoes. See your doctor if you have persistent foot pain that affects your ability to walk properly.
The treatment options vary with the type and severity of each hammer toe, although identifying the deformity early in its development is important to avoid surgery. Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.
Non Surgical Treatment
Padding and Taping. Often this is the first step in a treatment plan. Padding the hammertoe prominence minimizes pain and allows the patient to continue a normal, active life. Taping may change the imbalance around the toes and thus relieve the stress and pain. Medication. Anti-inflammatory drugs and cortisone injections can be prescribed to ease acute pain and inflammation caused by the joint deformity. Orthotic Devices. Custom shoe inserts made by your podiatrist may be useful in controlling foot function. An orthotic device may reduce symptoms and prevent the worsening of the hammertoe deformity.
Joint resection procedures involves removing part of one of the two small joints of the toe directly underneath where the digit is crooked. The purpose is to make room for the toe to be re-positioned flat or straight. Because hammer toes become rigid or fixed with time, removing the joint becomes the only option when the knuckle is stiff. Its important to understand that this procedure does not involve the joint of the ball of the foot, rather the a small joint of the toe. Medical terminology for this procedure is called a proximal interphalangeal joint arthroplasty or a distal interphalangeal joint arthroplasty, with the latter involving the joint closer to the tip of the toe.
Early Development. The first year of life is important for foot development. Parents should cover their babies' feet loosely, allowing plenty of opportunity for kicking and exercise. Change the child's position frequently. Children generally start to walk at 10 - 18 months. They should not be forced to start walking early. Wearing just socks or going barefoot indoors helps the foot develop normally and strongly and allows the toes to grasp. Going barefoot outside, however, increases the risk for injury and other conditions, such as plantar warts. Children should wear shoes that are light and flexible, and since their feet tend to perspire, their shoes should be made of materials that breathe. Replace footwear every few months as the child's feet grow. Footwear should never be handed down. Protect children's feet if they participate in high-impact sports.