Normally, toes should be positioned relatively straight when standing and walking. We have several large and small tendons that hold the toe in a rectus position when standing, help raise the toes when swinging the leg to the next step, and flex the toes against the ground to aid in balance. Occasionally, due to genetics, injury, biomechanical instabilities, collagen diseases, etc an imbalance of the tendon and joint complex can cause the toe to form a curved position.
Not all hammertoes are created equal, and these deformities are classified in several different ways. The doctor will first determine if the toes are rigid or flexible. When the toe is flexible, it can be manually straightened; when it is rigid, it will hold its position regardless of an outside force. This difference can change treatment options. Also, the position of the deformity but be evaluated. Most of our toes have three different joints and the deformity can be located at each joint or all of the joints. Not only can the toe be flexed and or elevated, it can also lean sideways to the 1st or 3rd toes.
Conservative: Conservative treatment for hammertoes often will require a change in shoe gear with wider/deeper shoes, padding, pairing of corns and calluses, and/or strapping. Unfortunately, as the hammertoe is caused by an imbalance of bone, muscle, and tendon, conservative methods will not straighten the toe permanently.
Surgical: Surgical correction of hammertoes is often only needed when there is associated pain that is not improved with conservative treatment. It can range from a small percutaneous procedure to cut a tendon to a larger reconstruction of the toe and possibly foot. The surgeon must evaluate all levels of deformity and musculoskeletal imbalances to choose an appropriate procedure to correct the deformity. Recovery depends on the procedure of choice. Most hammertoe procedures are outpatient in a surgical center where the patient can walk the day of surgery. For best outcomes, rest and elevation of the foot is always recommended.
If you have any questions or would like a consultation for painful hammertoes, please call 513-474-4450 to schedule an appointment.Leave a reply