is a Z-shaped deformity caused by dorsal subluxation at the metatarsophalangeal joint.
Diagnosis is clinical. Treatment is modification of footwear and/or orthotics. The usual cause is misalignment of the joint surfaces due to a genetic predisposition toward aberrant foot biomechanics
and tendon contractures. RA and neurologic disorders such as Charcot-Marie-Tooth disease are other causes.
Claw, hammer and mallet toe are most commonly caused by wearing high heels or ill-fitting shoes that are too tight e.g. narrow toebox. If shoes like this are worn for long periods, the foot is held
in a slightly bent position and gradually over time, the muscles tighten and shorten. If this continues for long enough, then the muscles become so tight that even when shoes are removed, the toe is
still held in the bent position. Another common cause is Morton?s Toe, where the second toe is longer than the big toe. In this case, the second toe is commonly squashed into a shoe into an
unnaturally bent position.
The most common symptoms of hammertoes include. The toe is bent upward at the middle toe joint, so that the top of this joint rubs against the top of the shoe. The remainder of the toe is bent
downward. Pain upon pressure at the top of the bent toe from footwear. The formation of corns on the top of the joint. Redness and swelling at the joint contracture. Restricted or painful motion of
the toe joint. Pain in the ball of the foot at the base of the affected toe. This occurs because the contracted digit puts pressure on the metatarsal head creating callouse and pressure on the ball
of the foot.
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
If the affected toe is still flexible, you may be able to treat it by taping or splinting the toe to hold it straight. Your family doctor can show you how to do this. You may also try corrective
footwear, corn pads and other devices to reduce pain. You may need to do certain exercises to keep your toe joints flexible. For example, you may need to hammertoe
move and stretch your toe gently with your hands. You can also exercise by
picking things up with your toes. Small or soft objects, such as marbles or towels, work best. If your hammer toe becomes painful, you may need to apply an ice pack several times a day. This can help
relieve the soreness and swelling. Nonsteroidal anti-inflammatory medicines (also called NSAIDs), such as ibuprofen (two brand names: Advil, Motrin) or naproxen (one brand name: Aleve), may be
helpful. If your pain and swelling are severe, your doctor may need to give you a steroid injection in the toe joint.
There are several surgical techniques used to treat hammertoes. When the problem is less severe, the doctor will remove a small piece of bone at the involved joint and realign the toe joint. More
severe hammer toes may need more complicated surgery.