A commentary on hammer toe and its complications
ISSN: 2329-910X

Clinical Research on Foot & Ankle
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  • Commentary   
  • Clin Res Foot Ankle, Vol 9(6)
  • DOI: 10.4172/2329-910X.1000313

A commentary on hammer toe and its complications

Yasuhiro Shirai*
*Corresponding Author: Yasuhiro Shirai, Department of Orthopaedic Surgery, Nagoya City University, Japan, Email: [email protected]



Keywords: Hammer Toe, Malformations, Arthrodesis


One of the most common malformations of the second, third or fourth toe is hammer toe. This condition is caused by wearing narrow shoes with little to no arch support. Although it can be painful, there are treatments available to alleviate the discomfort. A hammer toe is defined as a toe with an unnatural bend in its middle joint, which causes the toe to bend downward and resemble a hammer. An imbalance in the surrounding muscles, tendons, or ligaments that ordinarily hold the toe straight causes this painful ailment.

Hammer toes are flexible. If hammer toes aren't addressed right away, they can become fixed and require surgery to fix.

A muscular imbalance in the toes causes hammer toe. The most common symptom is a hammer-like twisted toe. Hammer toes get worse if they aren't treated right away. Hammer toe can be treated and prevented with simple workouts.

Causes of Hammer Toe

An imbalance in the muscles surrounding the middle toe joint causes hammer toe. To bend and straighten the toes, these muscles, tendons, and ligaments work together. The toe cannot bend or straighten if one of the muscles weakens. If the toe is bent for a long time, the muscles will tense and the toe will be unable to straighten. A lot of reasons contribute to muscle weakness and imbalance. Because some of the reasons of hammer toe can be avoided, the chance of acquiring hammer toe can be reduced. Age as you become older, your risk increases. Hammer toe is more likely to occur if the second toe is longer than the big toe.

People with certain disorders, such as arthritis or diabetes, are more likely to develop foot problems, such as hammer toe. Hammer toe is occasionally inherited, and it can run in families. Women are more likely than males to deform their feet as a result of their footwear styles.

Wearing high heels or shoes that are overly snug in the toe box might force toes into a flexed position. Even when barefoot, the toes may be unable to straighten with prolonged use. Women are more likely than men to acquire hammer toe. Injury Hammer toe is more likely to form if a toe is broken, stubbed, or jammed. The following are some of the signs and symptoms of hammer toe: The affected toe hurts, especially when you move it or wear shoes. Corns and callouses on the top of the hammer toe's middle joint. Swelling, redness, or a burning feeling is all possible symptoms. Impossibility of straightening the toe. In severe situations, open sores on the toe may occur. During an examination, a doctor will usually diagnose hammer toe. To produce symptoms, the doctor may move the foot and toe lightly. This allows the doctor to thoroughly assess the toe's condition. In a foot exam, hammer toe is frequently visible. A doctor may, however, order X-rays of the foot to study the diseased foot's bone structure further.

Complications and Risk Factors

Hammer toes are a degenerative condition that gets worse with time. The toe joint may become fixed if not addressed early, necessitating surgery to realign it. The more a person with hammer toe wears unsuitable footwear and ignores the developing hammer toe, the more likely it is that surgery to release the tendons will be required.

While hammer toe is not a medical emergency, it does worsen over time. People should consult a doctor as soon as they see any signs of hammer toe or other foot problems. People who are being treated for hammer toe should see a doctor if the problem worsens or does not improve with the suggested therapy. In extremely rare cases, a patient may need to be hospitalised.

Mild hammer toe treatment:A doctor may propose the following treatments if the hammer toe is treated while the toe is still flexible: Picking up marbles with your toes, for example. Changing to suitable shoes with low heels and a large toe box. Manually stretching the toe many times per day. A podiatrist might be able to make a shoe insert to relieve pain and prevent the hammer toe from getting worse.

Surgery on the Hammer Toe

A doctor may propose toe surgery if the hammer toe cannot be repositioned. The procedure tries to correct tendons, reposition the toe, and remove any malformed or injured bone. Surgery is frequently performed as an outpatient operation, which means that the patient can usually return home the same day.

Surgical Methods that may be Used Include

Half of the joint under the crooked section of the toe is removed during arthroplasty to assist the toe straighten.

Arthrodesis identical to the previous procedure, but the entire joint is removed and a wire or pin is implanted to aid in healing.

Tendon transfer to facilitate straightening, tendons from under the toe are redirected to above the toe. This technique can be combined with additional surgical procedures individuals with significant stiffness may benefit from a basal phalangectomy. Underneath the toe, the base of the bone is removed.

The metatarsal bone is shortened and surgical hardware is placed to assist healing in the Weil osteotomy procedure


Wearing right footwear can prevent hammer toe, as well as many other foot ailments. The following characteristics should be present in proper footwear: Higher heels pull the feet into unnatural positions and frequently bend the toes. Low heels are the opposite.

There should be enough toe room in shoes, and pointy-toed shoes should be avoided. Shoes should be able to fit the longest toe, which isn't typically the big toe. Adjustability the best sneakers include adjustable laces and straps. Arch support - arch support helps to prevent a variety of foot problems.

Simple workouts and footwear changes can help to treat and prevent hammer toe. However, if the toe becomes inflexible, surgery to alleviate the hammer toe may be required. Hammer toe can reappear even after therapy. Choosing suitable footwear is the greatest method to ensure that hammer toe does not recur.

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