Hammer toes 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.
Your toe contains two joints that allow it to bend at the middle and bottom. A hammertoe occurs when the middle joint becomes dislocated. Common causes of this joint dislocation include a toe injury, arthritis, a high foot arch, wearing shoes that don?t fit properly, tightened ligaments or tendons in the foot, pressure from a bunion (when your big toe points inward toward your second toe) Spinal Hammer toes cord or peripheral nerve damage may cause all of your toes to curl downward.
People with a hammer toe will often find that a corn or callus will develop on the top of the toe, where it rubs against the top of the footwear. This can be painful when pressure is applied or when anything rubs on it. The affected joint may also be painful and appear swollen.
First push up on the bottom of the metatarsal head associated with the affected toe and see if the toe straightens out. If it does, then an orthotic could correct the problem, usually with a metatarsal pad. If the toe does not straighten out when the metatarsal head is pushed up, then that indicates that contracture in the capsule and ligaments (capsule contracts because the joint was in the wrong position for too long) of the MTP joint has set in and surgery is required. Orthotics are generally required post-surgically.
Non Surgical Treatment
Inserts in your shoes can be used to help relieve pressure on the toes from the deformity. Splints/Straps. These can be used to help re-align and stretch your toes and correct the muscle imbalance and tendon shortening. One of the most common types are toe stretchers like the yogatoe. Chiropody. A chiropodist can remove calluses or corns, areas of hard skin that have formed to make the foot more comfortable.Steroid injections can help to reduce pain and inflammation.
Joint resection procedures involves removing part of one of the two small joints of the toe directly underneath where the digit is crooked. The purpose is to make room for the toe to be re-positioned flat or straight. Because hammer toes become rigid or fixed with time, removing the joint becomes the only option when the knuckle is stiff. Its important to understand that this procedure does not involve the joint of the ball of the foot, rather the a small joint of the toe. Medical terminology for this procedure is called a proximal interphalangeal joint arthroplasty or a distal interphalangeal joint arthroplasty, with the latter involving the joint closer to the tip of the toe.