HAMMERTOE
A hammertoe deformity is a contracture of a lesser toe (all toes with exception of big toes), most frequently with the second toe. It can lead to painful corns, rubbing of the skin in shoes, wounds, and general shoe fitting problems.
Custom orthoses and appropriate shoegear may slow the progression of the deformity for those with flat feet. But post-operatively, no conservative treatment will reverse the deformity. Ultimately, if the hammertoe causes pain or a limitation of lifestyle for the patient, then surgery would be the best option.
Surgical treatment depends on the severity and cause of the deformity. For milder cases, a tendon can be resected with minimal incision (1mm) on the non-visible underside of the toe with local anesthesia. This procedure is performed in the office and takes 5 minutes to perform. Moderate to severe cases requires that the procedure be performed in a surgery center or hospital. The procedure may either involve just a simple removal of bone, which heals in about 4 weeks, or a fusion technique with internal fixation, which would heal in approximately 6 weeks. Similar to a bunion post-op care, the patients may start walking on their new foot the very next day. Dr. Baik believes that early range of motion to the surgery site actually improves healing time by improving circulation, reducing scar tissue, and preventing muscle atrophy.
Generally, the hammertoe is caused by an imbalance of muscles and tendons that control the motion of the toe. The imbalance is usually genetic but certain shoegear, especially high heels and shoes with tight and narrow toe boxes can result in increased deformity.
Conservative treatment is limited to accommodation of the deformity. Shoe gear with a wider toe box and higher volume as well as padding will cause less friction to the toes.