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Hammertoes are a deformity that causes contracture (bending) of the joints in the second, third, fourth, or fifth toe. Tightened ligaments and tendons cause the toes to curl downward, resembling a hammer or a claw.

Hammertoes can cause significant discomfort. In the early stages of the deformity, the joints in the toes are still flexible. If left untreated, hammertoes can become rigid, making any type of movement painful.

Causes of hammertoe

Hammertoes are caused by a muscle imbalance in the foot. This type of structural imbalance causes the ligaments and tendons in the foot to become too tight, forcing the toes to curl downward.

Any of the following factors can contribute to a muscle imbalance in the foot, leading to hammertoe deformities: 

  • Arthritis. 
  • Genetics. 
  • Injury (breaking the toe or stubbing the toe). 
  • Nerve damage. 
  • Pressure from a bunion. 
  • Stroke.
  • Wearing improper footwear (particularly high-heeled shoes and shoes with a narrow toe box).

Hammertoe symptoms

Hammertoe deformities cause the middle joints of the toe to push upward while the tip of the toe curls downward. This "hammer-like" appearance is the obvious symptom of hammertoe.

Other common symptoms of hammertoe include: 

  • Corns and calluses on or in between the toes. 
  • Inflammation. 
  • Limited movement of the toes.
  • Pain near the toe joint (usually from pressure while wearing shoes).

As hammertoe progresses, the affected toes may rise and begin to overlap other toes. At this point, it is important to seek treatment.

Treatment of hammertoes

Initial treatment of the hammertoe deformity is designed to reduce symptoms and make movement easier. Patients are advised to wear comfortable shoes with wide toe boxes. Your physician can provide custom orthotics, corn pads, or splint the toe to keep it straight.

Surgery may be required if hammertoes become rigid and painful. A surgeon can lengthen the tendons to allow the toe to uncurl, or can remove a small wedge of bone from the toe to reduce the angle of contracture.

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