Hammertoes

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It is not exactly known where the term hammertoe originated. Some say it is because the toe looks a lot like the head of a hammer and some say that it is because people with hammertoes are tempted to hit the toe with a hammer in an attempt to straighten it! Figure 1.

What is the problem?

In a "normal toe", the tendon on the top of the toe and the tendon on the bottom of the toe are in balance Figure 2. The process of development of a hammertoe begins when these tendons are no longer in balance. As this process begins, you will notice that your toe is no longer flat but is slightly bent Figure 3. At this stage of development there is very little pain and the toe can be manually straightened. If the process is allowed to continue, the toe will begin to loose its "flexibility" as the bone begins to adapt to its new position Figure 4. It is at this point that the toe
will begin to become painful as it rubs on the shoe. Often a :"corn" will form on the top of the joint where it is rubbing. This then is a true hammertoe.

What can be done?

In the early stages of development while the toe is still flexible Figure 5, a simple tendon balancing procedure can be done. This is the time when this deformity is most easily corrected! This procedure is an office procedure and it is done with a small amount of anesthesia. After the area is anesthetized, a very small pointed blade is used to create a puncture hole on the top of the foot over the tendon. A second small incision is made on the bottom of the toe and through these incisions, the tendon is relaxed Figure 6. There are no sutures required and only a small dressing is applied. After several days, the dressing is removed and a band aid is used to splint the toe Figure 7.

When the toe has been allowed to become a rigid hammertoe, it is still a relatively simple task to correct it. This procedure is generally done in the Ford Center for Foot Surgery and can be done with either a local anesthetic or with sedation. When this has occurred, there is generally an overgrowth of bone at the "knuckle" of the toe Figure 8.
An incision is made on the top of the toe and the portion of the bone that has enlarged is then removed. In most instances, a flexible implant is then inserted in order to maintain a cosmetically acceptable toe and to maintain motion in the joint Figure 9. The toe is then splinted in the corrected position and a comfortable shoe is worn for several weeks. It is generally not necessary to take more then several days off of work for this procedure unless multiple toes are being corrected at the same time.