A hammer toe is a toe that is severely and abnormally curled or bent into a hooked shape similar to the claw end of a hammer. The bent or crooked portion often forms blisters, corns or calluses as a result of increased friction between the skin and footwear. Hammer toes tend to occur more commonly among people with very long toes that are out of proportion with the rest of the foot, causing the toes to become bent and cramped inside the shoes. Over time, the joint can become permanently bent, causing discomfort when wearing shoes.
Hammer toes form in people who wear shoes that don’t provide enough room in the toe portion of the shoes and in those with specific types of foot shapes. When the toe becomes crowded, it assumes the characteristic clawlike-appearance, and over time, the muscles, tendons, and ligaments that support the joint become permanently contracted. Initially, the joint will be flexible, enabling the toe to be straightened. But over time and without treatment, the joint can become permanently deformed. Hammer toes can form at any age, and they’re more common among people who wear high heels or narrow shoes, as well as those with arthritis or whose toes have been injured. They may also occur more commonly among people with impaired circulation, including those with diabetes.
Hammer toes that are still flexible may be treated with gentle stretching exercises to “loosen” tendons and ligaments, as well as custom orthotics to help the toe remain in its normal position. Splints worn at night can also gently move the toe into a normal, straightened position. Once the toe joint becomes stiff, surgery may be required to correct the shape and position of the joint. One or more small incisions will be made over the joint so to provide access and allow the doctor to restore the normal position of the bones and ligaments. Tiny pins or screws are often used to help the joint retain its position and prevent the toe from curving abnormally.
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