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Hammertoe is a contracture (bending) of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.
Common symptoms of hammertoe include pain or irritation of the affected toe when wearing shoes, corns on the top, side or end of the toe, or calluses on the bottom of the toe or on the ball of the foot. Calluses are a toughened buildup of skin, while corns are similar - although they can be hard or soft. Both can be painful and make it difficult to find comfortable shoes. But even without corns or calluses, hammertoes can cause pain because the joint itself may become dislocated.
Like many structural foot problems, hammertoes are progressive. They start as mild deformities and get progressively worse over time. If treated early, hammertoes are flexible, and the symptoms can be often be dealt with non-invasively. Left untreated, though, hammertoes can become more rigid and won't respond to non- surgical treatment. Corns are more likely to develop as time goes on and corns never really go away, even after trimming. Open sores may form in more severe cases.
The most common cause of hammertoes is an imbalance of the muscles and tendons in the foot that leads to a bending of the toe. Structural changes in the foot over time in some people lead to this imbalance. Sometimes hammertoes are caused by some kind of trauma, like a previously broken toe. Some people inherit the condition. Poorly fitted shoes, particularly shoes that are too short, can cause and/or aggravate hammertoes.
It's imperative that you have hammertoes examined by your foot doctor. Depending on the severity, it's quite possible that your podiatrist may be able to employ non-invasive forms of treatment. These include trimming or padding corns and calluses (never trim corns and calluses yourself, as you run the risk of cuts and infection), changes in shoewear, orthotics, splinting or strapping of the toe to realign it, or oral or injected medication.
Sometimes, usually when the hammertoe has become more rigid, surgery is needed to relieve the pain and discomfort. Your podiatric surgeon can examine your situation and, taking into account factors such as your age, activity level, and the number and severity of the toes involved, discuss and implement a surgical option.
The most common surgical procedure to correct a hammertoe is called arthroplasty and involves the surgeon removing a small section of bone from the affected joint. Another procedure, arthrodesis, is usually employed in more severe cases. Arthrodesis involves fusing a small joint in the toe to straighten it. Sometimes other treatments, such as tendon and muscle rebalancing or lengthening, are called for in addition to the procedures above.