What could be my problem?
A hammer toe has an abnormal bend in the middle joint of the toe. Mallet toe affects the joint nearest the toenail. Hammertoe and mallet toe usually occur in the second, third and fourth toes. Initially, hammer and mallet toes are flexible and can be corrected with simple measures but, if left untreated the toes can become fixed and require surgery.
People with hammer toe or mallet toe may also have corns and calluses on the top of the middle joint of the toe or on the tip of the toe. With this condition there may also be pain in the toes or feet and may have difficulty finding comfortable shoes.
What causes Hammer Toe and/or Mallet Toe?
- Foot deformities that occur due to an imbalance in the muscles, tendons or ligaments that normally hold the toe straight.
- The type of shoe worn, foot structure, trauma and certain disease processes can contribute to the development hammer toe/mallet toe.
When to see a foot specialist about Hammer Toe/Mallet Toe:
- When toes are bent upward (extension) from the joints at the ball of the foot.
- When toes are bent downward (flexion) at the middle joints toward the sole of your shoe.
- When toes are bent downward at the top joints, curling under the foot.
- If painful corns develop over the top of the toe or under the ball of the foot.
- To rule out neurological disorders that can weaken your foot muscles, creating imbalances that bend your toes.
- If a foot injury (trauma) and/or inflammation cause hammer/mallet toe deformity.
- Persistent foot pain that affects your ability to walk or an inability to wear proper footwear that may interfere with a normal gait.
- An abnormal gait that may be causing pain and orthopedic problems in the ankle, knee, hip or spine.
What are my treatment options for Hammer or Mallet Toe?
If your toe is still flexible:
- Footwear with soft, roomy toe boxes – avoid tight shoes and high heels.
- Exercises to stretch and straighten the toe.
- Custom orthotics or pads to reposition your toe, relieve pressure and keep your hammertoe from getting worse.
If conservative treatments don’t help, your foot doctor may recommend surgery to treat the pain.
- Flexible Hammer Toe/Mallet Toe: A tendon transfer procedure is used to correct the problem by repairing the tendons from the bottom of the toe to the top of the toe where it is sticking up. This helps pull the bent joint into a straight position.
- Fixed (stiff) Hammer Toe/Mallet Toe: There are two options for treatment;
a) Joint resection can be used to treat the fixed hammer toe by making an incision over the top of the toe. Ligaments and tendons may be cut to help with straightening the toe. The end of the bone is removed to allow the toe to straighten completely, and pins are temporarily used to hold the toe straight. The pins are usually removed three to four weeks after surgery.
b) Fusion: Can also be used to treat fixed hammer toe by cutting the ligaments and tendons to help straighten the toe. The ends of the bone are cut and the toe is straightened. Pins, screws or other implants can be used to keep the toe straight while the bone ends heal together.