Hammer Toes

What Is It?

A hammer toe is a deformity in which one or more of the smaller toes (most often the 2nd, 3rd, or 4th) bend abnormally at the proximal interphalangeal joint (knuckle), resembling a hammer.

This occurs due to muscle/tendon imbalance, foot structure, trauma, or chronic pressure from shoes. Often, hammer toes will be concurrent with bunions or other foot and ankle pathologies. Patients who have arthritis can also develop hammer toes.

Over time, the joint becomes stiff, painful, and the toes may develop corns or calluses from rubbing.

The tips of the toes will often develop thick calluses, and can develop wounds, from repeated pressure during ambulation (walking).

Hammer toes are progressive, meaning they tend to worsen without treatment.

Other digital (toe) pathologies include claw toe and mallet toe, which are similar to hammer toes, however the deformity will lie in a different joint of the toe.

Treatment Plan for Hammer Toes

• Shoe Modification: Wear wide, deep toe box shoes to reduce pressure on the toes. Avoid high heels and narrow shoes.
• Padding: Gel pads, corn pads, or silicone sleeves can reduce irritation.
• NSAIDs: For pain and inflammation.
• Surgery: For fixed or painful deformities that fail conservative treatment. Procedures may include tendon release, joint resection, or fusion.

Some of these procedures can be done in the office without utilization of general anesthesia and minimal recovery time.

Avoid:

• Tight, narrow shoes or high heels.
• Ignoring painful corns/calluses (can lead to wounds, especially in diabetics).