Podiatry Terms & Descriptions – Hammertoes

What are Hammertoes? 


Toes are often overlooked and under-appreciated by many of us. After all, what do they do beside rub in your shoes and often get cramped?

During gait, the arch of the foot naturally depresses to help absorb shock. One of the ways that the arch tries to elevate again is accomplished is by the gripping of the toes.

They help to stabilize the metatarsal heads, pull the heel bone further forward to shorten the arch and elevate the heel.
During the process of gait, if an abnormal amount of force is misdirected, (the arch being too low or the foot being too unstable) the toes must over grip and increase their actions. Often times this leads to a muscular imbalance causing deformity to the toes.

Hammer Toe Deformity is the primary development of deformity of the toes. Hammer Toe occurrence is the development of an angular (twisting) position of the toe. The position of the toe causes rubbing and irritation in the shoe which produces pain.

What Causes Hammertoes?

Hammer toe deformity can be congenital (such as in clinodactyly, polydactyly and syndactyly) or developmental such as in adducto Varus deformity, flexor stabilization or flexor substution.

In the congenital development, an abnormal development of the bones, skin or insertion of the tendon has occurred which produces an abnormal position of the toe.

In the developmental development of Hammer Toe deformity, each step of an unstable foot has caused the toes to over exert themselves in trying to help stabilize the foot during gait. This produces a muscular imbalance with progressive shortening of the flexor tendons (the deforming force) and the extensor tendons (the holding force). The result is an angular mal position of the toe causing rubbing in shoes with pain.

Treatment for Hammertoes

Conservative treatment of conditions of the toes can be the use of a wider shoe, looser socks, Vaseline and pads. This can be suggested by your Podiatric Physician.

When is Surgery for Hammertoes Necessary?

Surgical treatment of Hammer toe deformity lies in the potential of producing a straight stable toe during gait and the avoidance of rubbing in shoes. This can be accomplished by reducing (lengthening) the contracted tendons and joint capsule and by removing a piece of the joint (knuckle) when prominent to allow room to straighten. Artificial joints and metal pins are some times used to help stabilize the toe during the healing period. If not sufficient enough to stabilize, then arthrodesis may be suggested.