If you think you may have hammertoes, you’re not alone; it’s actually one of the most common foot deformities of the 2nd through 4th toes. The proximal interphalangeal (PIP) joint becomes over flexed while the two surrounding joints, the metatarsophalangeal (MTP) and the distal interphalangeal (DIP) joints, become hyper-extended. The disorder could be caused from many things including improperly fitting shoes, a 2nd digit longer than the first, genetics, and nerve or muscle damage.
The Problem
The flexed PIP joint can rub against the top of shoes causing pain and corns. The over extended MTP joint feels extra pressure when walking and calluses can form. Over time, this joint may become dislocated.
When the deformity is new it is flexible and can be pushed or held in the correct position, but as it progresses the deformity can become fixed and only correctable with surgery.
What We Can Do to Help
Non-operative treatment involves wearing shoes with roomy toe boxes, using a hammertoe splint or taping the toe with neighboring toes to help prevent pain caused by rubbing against the shoes. Although these treatments successfully relieve pain caused by the deformity, it still typically progresses and becomes more rigid.
Surgery for this deformity can involve one or a couple procedures including tendon release, PIP joint resection or joint fusion. Surgery for both rigid and flexible hammertoe is successful in relieving pain and correcting the deformity. Once corrected, the rigid deformity rarely reoccurs; but, the flexible deformity can reappear, especially if the patient continues wearing improper shoes.
Surgery is only performed in cases where the patient is in pain, it’s not performed for cosmetic purposes. Surgery is most commonly performed in cases where the deformity is rigid, but your doctor can help you decide which treatment option is best for you.