Overview
Hammer toe, 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.
Causes
A person may be born with hammer toe or may develop it from wearing short, narrow shoes. Hammer toe can occur in children who outgrow shoes rapidly. Sometimes hammer toe is genetic and is caused by a nerve disorder in the foot. High heeled shoes are can also cause hammer toe. The reason for this is that the toes are not only bunched up, but the weight of the body is pushing them forward even further.
Symptoms
Hammer, claw, and mallet toes can cause discomfort and pain and may make it hard to walk. Shoes may rub on your toes, causing pain, blisters, calluses or corns, or sores. Sores can become infected and lead to cellulitis or osteomyelitis, especially if you have diabetes or peripheral arterial disease. If you have one of these health problems and sores develop, contact your doctor.
Diagnosis
Some questions your doctor may ask of you include, when did you first begin having foot problems? How much pain are your feet or toes causing you? Where is the pain located? What, if anything, seems to improve your symptoms? What, if anything, appears to worsen your symptoms? What kind of shoes do you normally wear? Your doctor can diagnose hammertoe or mallet toe by examining your foot. Your doctor may also order X-rays to further evaluate the bones and joints of your feet and toes.
Non Surgical Treatment
Mild hammer toe in children can be treated by manipulating and splinting the affected toe. The following changes in footwear may help relieve symptoms. Wear the right size shoes or shoes with wide toe boxes for comfort, and to avoid making hammer toe worse. Avoid high heels as much as possible. Wear soft insoles to relieve pressure on the toe. Protect the joint that is sticking out with corn pads or felt Hammer toe pads. A foot doctor can make foot devices called hammer toe regulators or straighteners for you, or you can buy them at the store. Exercises may be helpful. You can try gentle stretching exercises if the toe is not already in a fixed position. PIcking up a towel with your toes can help stretch and straighten the small muscles in the foot.
Surgical Treatment
If your toe is not bendable, your doctor may recommend surgery. The type of surgery that will be performed will depend on the severity of the condition. You should expect blood and urine studies before the procedure, as well as x-rays of your feet. Your doctor will inject either a local or regional anesthetic. If your toe has some flexibility, the doctor may be able to straighten it by simply making an incision in the toe to release or lengthen the tendon. If the toe is not flexible, your doctor will probably make the same incision to release the tendon, but he or she may also remove some pieces of the bone so that the bone can be straightened. A k-wire is placed in the toe to help hold it straight while it is healing. This is taken out after about four weeks.
Prevention
Most cases of hammertoe can be prevented by wearing shoes that fit properly and give the toes plenty of room. Some recommended guidelines include avoid shoes with pointed or narrow toes. Avoid shoes that are too tight or short. Avoid high-heeled shoes, which can force the toes forward. If the shoes hurt, don’t wear them. Choose shoes with wide or boxy toes. Choose shoes that are a half-inch longer than your longest toe.
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