Hammer Toe

(Hammertoe)

Definition

A hammer toe is a toe that tends to remain bent at the middle joint in a claw-like position. There are 2 types of hammer toe:
  • Flexible hammer toe—can be straightened by hand
  • Rigid hammer toe—cannot be pulled straight and can be extremely painful. The position of the toe can also lead to corns or calluses. These may also be painful.
Hammertoe
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Causes

Hammer toe may be present at birth or develop later in life due to tendons that have tightened, causing the toe's joints to curl downward.Occasionally, all toes may be bent. This may be due to problems with the peripheral nerves or the spinal cord.

Risk Factors

Factors that increase your chance of getting hammer toe include:
  • Family history of hammer toe
  • Arthritis
  • Foot and ankle abnormalities
  • Frequent use of the inappropriate footwear:
    • Shoes that don't fit properly, for either an adult or child
    • High heels
    • Narrow-toed shoes
  • The foot having a high arch
  • Muscle weakness in the foot
  • Nerve damage in the foot
  • Injury to a toe

Symptoms

If you have any of these symptoms, do not assume it is due to hammer toe. Talk to your doctor about symptoms such as:
  • A toe that curls down
  • Corns on the top of a toe
  • Calluses on the sole of the foot or bottom of the toe
  • Pain in the middle joint of a toe
  • Discomfort on the top of a toe
  • Difficulty finding any shoes that fit comfortably
  • Cramping in a toe, and sometimes also the foot and leg
  • Difficult or painful motion of a toe joint
  • Pain in the ball of the foot or at the base of a toe

Diagnosis

You will be asked about your symptoms and medical history. A physical exam of the toe will be done. Your doctor can diagnose hammer toe by its appearance.

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

Supportive Care

The toe will need time to heal. This may include:
  • Splinting the affected toe
  • Switching to properly sized footwear with roomy toe boxes
  • Splints, straps, cushions, or corn pads to relieve symptoms

Corrective Surgery

Severe cases require an operation to straighten the joint:
  • Tendons may be cut or transferred
  • The middle joint of the toe may be fused together
  • Part of the toe or joint may be removed

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Prevention

To help reduce your chances of getting hammer toe, take the following steps:
  • Avoid wearing poorly fitting or narrow-toed shoes.
  • Avoid heels higher than 2 inches.
  • Check your child’s shoe size often.

RESOURCES

American Podiatric Medical Association
http://www.apma.org

OrthoInfo—American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org

CANADIAN RESOURCES

Health Canada
http://www.hc-sc.gc.ca

Nurses Entrepreneurial Foot Care Association of Canada
http://www.nefca.ca

References

Hammer toe. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00160. Updated September 2012. Accessed March 2, 2015.

Hammertoe. Foot Health Facts—American College of Foot and Ankle Surgeons website. Available at: http://www.foothealthfacts.org/footankleinfo/hammertoes.htm. Accessed March 2, 2015.

Hammer toe. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 25, 2010. Accessed March 2, 2015.

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