There are two different types of hammertoes
. Flexible Hammer Toes. These hammer toes are less
serious because they can be diagnosed and treated while still in the developmental stage. They are called flexible hammer toes because they are still moveable at the joint. Rigid Hammer Toes. This
variety is more developed and more serious than the flexible condition. Rigid hammer toes can be seen in patients with severe arthritis, for example, or in patients who wait too long to seek
professional treatment. The tendons in a rigid hammer toe have become tight, and the joint misaligned and immobile, making surgery the usual course of treatment.
Hammertoes are usually structural in nature. Many times this is the foot structure you were born with and other factors have now made it so that symptoms appear. The muscles in your foot may become
unbalanced over time, allowing for a deformity of the small bones in each toe. With longstanding deformity the toe may become rigid. Sometimes one toe is longer than another and this causes a
buckling of the digit. A hammertoe may also be caused by other foot deformities such as a bunion. Trauma or other surgery of your foot may predispose you to having the condition if your foot
structure is altered.
A soft corn, or heloma molle, may exist in the web space between toes. This is more commonly caused by an exostosis, which is basically an extra growth of bone possibly due to your foot structure. As
this outgrowth of excessive bone rubs against other toes, there is friction between the toes and a corn forms for your protection.
Hammertoes are progressive, they don?t go away by themselves and usually they will get worse over time. However, not all cases are alike, some hammertoes progress more rapidly than others. Once your
foot and ankle surgeon has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.
Non Surgical Treatment
Treatment for a hammertoe usually depends on the stage of the hammertoe and the cause of the condition. If your toe is still bendable, your doctor may suggest conservative care-relieving pressure
with padding and strapping, or proper shoes that have a deep toe box and are of adequate length and width. Early intervention can often prevent the need for surgery.
The deformity is corrected in a variety of ways. There are actually a large number of procedures. The simplest procedure would involve a Tenotomy, the cutting of the tendon causing the deformity or a
Tendon Lengthening procedure. These procedures are infrequently done, though, as the structural deformity (the arthritis and joint adaptation) is not addressed with these surgeries. Other soft-tissue
procedures involve rebalancing the tendons around the joint. There are several techniques to do Hammer toe
this, but the most common is probably the Girdlestone-Taylor procedure, which involves
rerouting the tendons on the bottom of the toe up and over the toe where it sticks up, so that the tendon helps pull the toe downwards into proper alignment.