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Hammer Toe is a deformity which causes one or more toes to bend downwards. The condition may occur in any toe but mostly affects the second or the third toe. A balance is maintained between the tendons, bones, muscles and ligaments which enable the toes to remain straight. Any factor that disrupts this balance may lead to Hammer Toe. Some people are born with this deformity while others may acquire it over a period of time due to various reasons.

Hammer Toe is classified into two categories:

Flexible Hammer Toe – It refers to the initial phase of the condition during which the toe can be straightened or moved with support

Rigid Hammer Toe – This is the severe or final phase of deformity when the toe is permanently bent and cannot be moved

Causes

  • Arthritis or age related degeneration of the bones
  • Wearing tight, pointy, high heeled or uncomfortable shoes
  • Damage to the spine or peripheral nerves
  • Bunion growth on the big toe may force the second to bend downwards
  • Tightening of the tendons and ligaments in the foot or toes
  • Muscular imbalance
  • Direct injury to any part of the toe
  • Genetically inherited weak muscular structure
  • Nerve damage in the foot
  • Diabetes
  • Certain foot structures are predisposed to developing Hammer Toe. For example, if the second toe is bigger than the big toe, chances of its bending are higher

Symptoms

  • Pain in the ball of the foot
  • Visibly deformed shape of toe
  • Growth of corns or calluses on the upper part of toe
  • Pain and irritation while wearing shoes
  • Difficulty in moving the toe
  • Redness on the upper part of the toe

Diagnosis

  • Physical examination of the affected toe
  • X-ray imaging to assess the changes in bone structure or ligaments
  • Evaluation of the patient’s medical and family history
  • The neurovascular functioning may be checked by palpation of pulses

Treatment

  • Wear soft and comfortable that have a sufficiently wide toe box
  • Doing exercises that make the toes more flexible and strengthen the muscles
  • Wearing a brace to keep the toe in a straightened position
  • Use of shoe inserts for even distribution of pressure
  • Surgical removal of a bone to flatten the toe
  • Surgical correction of tightened muscles, ligaments and tendons relieve pressure from the toe
  • Using a tape or toe sling to reposition the affected toe