Hammer Toes: Throw the kitchen sink at them

hammer toe

A hammer toe is one of the more common types of foot problems. A hammer toe is when (usually) one toe is drawn up and backwards, making the first joint in the toe stick up above the rest of the other toes. Technically, the definition of a hammer toe is: “A sagittal plane deformity of the toe where the proximal interphalangeal joint (PIPJ) is flexed, the distal interphalangeal joint (DIPJ) is in a neutral or extended position and the metatarsophalangeal joint (MPJ) is neutral or dorsiflexed.” The most common symptom of a hammer toe is a painful corn can form on the top of the prominent joint (from pressure between the toe and the shoe) or on the end of the toe (from pressure between the toe and the ground).

Causes of Hammer Toes

Inappropriate footwear – (narrow toe box, inadequate depth of toe box, too short, too small)
Associated with hallux abducto valgus
Familial predisposition/inherited factors
Neuromuscular disorders
Short hallux
Instability of the foot during propulsion  flexor stabilisation (could be most common cause)
Short or plantarflexed metatarsal
Imbalance between medial and lateral interossei

Consequences of Hammer Toes

Pain, shoes

Treatment of Hammer Toes

Conservtaive:

Budin Toe splint

Surgical:

Management:
Treat inflammatory states and reduce hyperatotic lesions.
Protective padding if fixed.
Corrective padding or splints if flexible
Orthodigital devices.
Footwear advice – deeper toe box

Surgical:
• Fusion of the IPJ in a slightly flexed position
• Dorsiflexion osteotomy of a plantarflexed ray
• Surgical correction of HAV
• Tendon transfers
• Removal of bony segments – resection of proximal interphalangeal joint
• Soft tissue procedures to release contractures
• K-wire insertion/fixation.

My Personal Opinion on Hammer Toes

Surgery

Forum discussions on Hammer Toes

Hammer toe surgery
The effect of a hammer toe on the windlass mechanism
Intrinsic foot muscle strengthening and hammer toe syndrome
Hammer Toes and Corns

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