Hammer toe

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Hammer toe

Definition

Hammer toe is a deformity of the toe, in which the end of the toe is bent downward.

Causes, incidence, and risk factors

Hammer toe usually affects the second toe, although it may also affect the other toes. The toe goes into a claw-like position. The condition may occur as a result of pressure from a bunion. A corn on the top of a toe and a callus on the sole of the foot develop, which makes walking painful.

The condition may be present at birth (congenital) or develop from wearing short, narrow shoes. Hammer toe also occurs in children who continue to wear shoes they have outgrown.

The rare case in which all toes seem to be involved may indicate a problem with the nerves or spinal cord.

Symptoms

• Callus forms on the sole of the foot
• Claw-like deformity of a toe
• Corn forms on the top of a toe
• Foot pain -- pain in the joint where the great toe joins the foot

Signs and tests

A physical examination of the foot confirms hammer toe.

Treatment

Mild hammer toe in children can be treated with foot manipulation and splinting the affected toe. Wear the right size shoes or shoes with wide toe boxes for comfort and to avoid aggravating hammer toes.

Protect the protruding joint with corn pads or felt pads, corrective footwear, or other foot devices. Exercises may be helpful.

Severe hammer toe requires an operation to straighten the joint. The surgery may involve cutting or moving tendons, or fusing the joints of the toe together.

Expectations (prognosis)

If the condition is treated early, you can often avoid surgery. Treatment will reduce pain and walking difficulty.

Complications

• Foot deformity
• Posture changes caused by difficulty in walking

Calling your health care provider

If you have hammer toe, call for an appointment with your health care provider for instructions on the best treatment.

Also call for an appointment if your pain gets worse or you have difficulty walking.

Prevention

Avoid wearing shoes that are too short or narrow. Check children's shoe sizes frequently, especially during periods of fast growth.

References

Badlissi F, Dunn JE, Link CL, Keysor JJ, McKinlay JB, Felson DT. Foot musculoskeletal disorders, pain, and foot-related functional limitation in older persons. J Am Geriatr Soc. 2005;53:1029-1033.

Review Date: 7/17/2008

Reviewed by: Andrew L. Chen, MD, MS, Orthopedist, The Alpine Clinic, Littleton, NH. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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