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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

    Hammer toe usually affects the second toe, although it may also affect the other toes. The toe assumes 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. A high foot arch may also develop.

    The condition may be congenital (present at birth) or acquired by wearing short, narrow shoes. The condition 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

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

    Exams and Tests

    A physical examination of the foot confirms the presence of hammer toe.

    Treatment

    Mild hammer toe in children can be treated with foot manipulation and splinting the affected toe. Properly-sized footwear or wide toe-box shoes usually provide comfort and can reduce aggravation of hammer toes. The protruding joint can be protected 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 transferring tendons or fusing the joints of the toe together.

    Outlook (Prognosis)

    If the condition is treated early, surgery can often be avoided. Treatment will reduce the associated pain and difficulty with walking.

    Possible Complications

    • Foot deformity
    • Posture changes caused by difficulty in walking

    When to Contact a Medical Professional

    Call for an appointment with your health care provider if hammer toe is present, for instructions on the best treatment.

    Also call for an appointment if pain gets worse or difficulty walking occurs.

    Prevention

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


    Review Date: 11/22/2004
    Reviewed By: Benjamin D. Roye, M.D., M.P.H., Division of Pediatric Orthopaedics, Beth Israel Medical Center, New York, NY. Review provided by VeriMed Healthcare Network.
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