Hammer Toes

A hammer toe is a deformity where the toe bends at the first joint (proximal interphalangeal joint), often causing irritation, painful corns, or calluses—especially when rubbing against shoes. This condition can make walking difficult and finding comfortable footwear challenging. For individuals with diabetes, hammer toes can lead to ulcers and infections. It’s a common foot condition, and if you suspect you have one, consult Dr. McAlister for more information and personalized treatment options.

Hammer Toes

 What is a Hammer Toe?

A hammer toe is a bending or contracture of the toe at the proximal interphalangeal joint, which is the first joint of the digit. This is oftentimes irritating and can develop painful corns or calluses, especially when these rub against shoes. You may even find it difficult to walk or find proper shoes. If you are a diabetic, they may even cause ulcers that can become infected. This is a very common foot condition, and if you suspect that you have this, discuss with Dr. McAlister for additional information and treatment options for your hammer toe.

Are there different types of hammer toes?

Any toe can be involved, and hammer toes can be either flexible or rigid. This indicates the severity of the condition, and as a result, the treatment will differ.

Flexible hammer toes are less severe and be treated conservatively with padding or in-office procedures. On the other hand, rigid hammer toes are much more serious and oftentimes require surgery. X-rays are usually ordered if surgery is indicated so that Dr. McAlister can tailor the surgical plan to your specific condition. 

What are the causes and risk factors?

Hammer toes can develop from a number of causes such as muscular imbalance, improper footwear, and trauma.

With regards to muscular imbalance, there are two categories of muscle tendons that power how you walk: muscles that bring your feet downwards (flexors) and muscles that bring your feet upwards (extensors). When there is one group overpowers the other, contractures of the toes can occur. This can lead to hammer toes or any other toe deformity.

Improper footwear can also be the culprit, especially in women. Narrow and ill-fitting shoes such as high heels or flats can put severe pressure to your toes and joints, and this can lead to hammer toes.

Trauma such as an injury in which you stub or jam a toe can make it likely to develop into a toe contracture. However, toe contractures from injury can be a more urgent matter especially when a ligament in the toe actually ruptures (known as a plantar plate rupture). Consult with Dr. McAlister immediately if you have had a recent injury that lead to a contracted toe.

What are my non-surgical options?

If your hammertoe is in the early stages and is considered a flexible contracture, then Dr. McAlister may offer the following conservative treatment options:

• Changes in footwear and orthotics: besides avoiding tight and narrow shoes, you may benefit from a over-the-counter or even a custom orthotic that can help with muscular imbalances that contribute to your condition.

• Exercise program: Dr. McAlister may offer a stretching program for you to help strengthen the muscles in your foot. 

• Taping and padding: Dr. McAlister may demonstrate taping techniques and offer padding that you can reproduce at home or put on your toe to offer a quick and temporary fix. 

• Callus and corn debridement: Dr. McAlister can quickly shave off the painful callus and corn with sterile equipment to help reduce the pain. 

• In-office procedures: After exhausting the options above, there is another treatment that Dr. McAlister may suggest which is called a flexor tenotomy to release the pull of the flexor tendon to relieve your hammer toe. Discuss with Dr. McAlister if this procedure is right for you. 

 What are my surgical options?

If you have exhausted all your conservative treatment option and the hammer toe has progressed into a rigid deformity, a surgical procedure may be the next step to help alleviate the pain and discomfort you feel. Dr. McAlister has trained and performed in hundreds of hammer toe corrections and is extensively qualified to help treat your condition.

Before your visit, Dr. McAlister may take some x-rays to assess the degree of your condition. He will then talk to you about your surgical options, which is not one-size-fits-all. As every hammer toe is unique, there are a number of surgical options that may be offered.

• Tendon lengthening: this surgery is for patients with a flexible hammer toe and help reduce the muscle imbalance by lengthening the flexor tendon.
• Tendon transfer: this procedure is when the tendon is repositioned in order to balance the toe.
• Arthroplasty: this procedure surgically removes a portion of the joint so that the deformity is decreased.
• Arthrodesis: this procedure fuses the affected joint so that it straightens the toe.

Some of these procedures may involve a small pin or wire that is to be left after the surgery is performed, so that the realigned toe can maintain the straightened position while healing. Once the healing process is complete, Dr. McAlister will remove the fixation device leaving behind a straightened toe that is pain-free.

Call Dr. McAlister’s office today to learn more about your hammer toe options!