What is a Hammer Toe, its symptoms, causes & surgical treatments?
31st Oct 2018
A Hammertoe, also known as a claw toe, is a deformity that gradually causes your toe to bend downward. The second, third, fourth or fifth toes are affected most often and the deformity usually develops over time as a result of chronic inflammation arthritis, ligament injury or wearing poorly-fitted shoes.
Symptoms of Hammer Toes
A Hammertoe is often uncomfortable when walking and may be painful when trying to move the toes. Specific symptoms often include:
- Pain on the top or tip of the affected toe and/or on the ball of the foot.
- The pain might range from dull and mild to severe and sharp and is often made worse by shoes, especially shoes that crowd the toes.
- Callus and corns might develop on the knuckle or ball of the foot as the result of pressure in footwear.
- The affected toes may become irritated and swollen.
Hammertoes may not cause pain in all cases, especially as the deformity begins to develop.
Causes of Hammer Toes
Common causes of Hammer Toes include:
- Family history or predisposition, such as an unusually high foot arch
- A traumatic toe injury
- Wearing shoes that don’t fit properly
- A Hammertoe is sometimes a result of other deformities, such as a bunion
When to Seek Hammer Toe Treatment
Hammertoes are progressive and will not resolve on their own. It is therefore advisable to see a specialist opinion if you suspect a Hammertoe. Often patients seek advice after the symptoms have become quite severe and begin to interfere with their quality of life or daily activities. If the condition is treated early on then simple measures can be taken to prevent progression of the deformity and relieve symptoms. In some cases, typically after a Hammertoe has become rigid and painful or when an open sore has developed, surgery is needed.
Hammer Toe Surgery
Surgical treatment can be helpful to:
- Straighten the toe into a cosmetically accepted position
- Minimise swelling
- Return to smart footwear
- Prevent recurrence of deformity
Non-Surgical Treatments For Hammer Toes
Unless the hammertoe has progressed to a stage that requires surgery, simple conservative measures are recommended in the first instance. These might include:
- Anti-inflammatory Medicines: To relieve pain and decrease inflammation
- Injections: A cortisone injection can further help relieve pain and inflammation in more severe cases
- Physical Therapy: Physiotherapy can be useful to stretch tight muscles and tendons that are causing the hammertoe
- Bespoke Orthotics: A biomechanical specialist can design and manufacture a custom insole to resolve discomfort and prevent progression of the deformity
- Toe Splints or Pads: Splints and pads can be helpful to realign the affected toe and prevent discomfort when walking in footwear
Hammer Toe Surgery Procedure
Hammertoe deformities are treated as a day case at the London Foot & Ankle Surgery, meaning that patients are able to go home on the same day after surgery. The three types of surgery most commonly performed are:
- K-Wire Arthrodesis – this is the traditional surgical technique. The deformed joint is removed and the toe is held in place with wires while it heals.
- Implant arthrodesis – this technique involves removal of the deformed joint and an internal implant holds the toe in place. (No wires sticking out of toe after the operation)
- Arthroplasty – the deformed joint is removed and the capsule is stitched in place to heal. This is generally used for fourth or fifth hammertoes so they can bend while fitting into shoes.
Hammer Toe Surgery Recovery
A full recovery following Hammertoe surgery can take up to 12 weeks.
First 2-4 days
You will be able to stand and take weight carefully after the operation with the use of crutches, but you will need to rest, with your feet up, as much as possible.
One week after surgery
You may start to do a little more within pain limits. Pain means you are doing too much.
Two weeks after surgery
Sutures will be removed if the skin has fully healed. You will not need a bandage, and you can get the foot wet.
Between 2-6 weeks after surgery
The toe starts to return to normal and you can return to shoes (3-5 weeks). You may return to work but may need longer if you have an active job. You may return to driving if you can perform an emergency stop. You must check with your insurance company before driving again. Whilst normal activity will be resumed, sport should be avoided.
Between 6-12 weeks after surgery
The foot should continue to improve and begin to feel normal again. There will be less swelling. You can return to normal activities.