A hammertoe is a deformity of the second, third, fourth, or fifth toe. In this condition, the toe is bent at the middle joint, so that it resembles a hammer. Initially, hammertoes are flexible and can be corrected with simple measures but if left untreated, they can become fixed and require surgery.
Hammertoes result from shoes that don’t fit properly or a muscle imbalance, usually in combination with one or more other factors.
Shoes that are narrow toward the toe push the smaller toes into a flexed (bent) position. The toes rub against the shoe, leading to the formation of corns and calluses, which further aggravate the condition.
People with hammertoes may have corns or calluses on the top of toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes.
Conservative treatment starts with new accommodative shoes that have soft, roomy toe boxes. Shoes should be half an inch longer than your longest toe. Avoid wearing tight, narrow, high-heeled shoes. You may also be able to find a shoe with a deep toe box that accommodates the hammertoe. Sandals may help, as long as they do not pinch or rub other areas of the foot.
Your doctor may recommend that you use foot pads, nonmedicated corn pads, orthotics, anti-inflammatory medications, or cortisone injections to relieve pain and swelling.
If conservative measures fail to resolve symptoms, surgery is then considered. Often, hammertoe surgery is performed as an outpatient. The actual procedure will depend on the type and extent of the deformity. The goal of surgery is to straighten and stabilize the toe. After the surgery, there may be some stiffness, swelling and redness and the toe may be slightly longer or shorter than before. You will be able to walk with a surgical shoe, but should not plan any long hikes while the toe heals, and you should keep your foot elevated as much as possible.