Hammertoes are a contraction of the toes as a result of a muscle imbalance between the tendons on the top and the tendons on the bottom of the toe. They can be flexible or rigid in nature. When they are rigid, it is not possible to straighten the toe out by manipulating it. Frequently, they develop corns on the top of the toe as a result of rubbing on the shoe. They may also cause a bothersome callus on the ball of the foot. This occurs as a result of the toe pressing downward on the bone behind the toe. This area then becomes prominent and the pressure of the bone against the ground causes a callus to form. They tend to slowly get worse with time and frequently flexible deformities become rigid. Treatment can be preventative, symptomatic or curative.
Conservative treatment of hammertoes consists of such things as open toed shoes or hammertoe pads. There are over the counter corn removers for temporally reducing the painful callous however these medications must be used with caution. They are a mild acid that burns and can remove good skin as well as callus. These medications should never be used for corns or calluses between the toes. Persons with or bad circulation should never use these products.
Corrective treatment of hammertoes varies depending upon the severity of the deformity. When the hammertoe is flexible, a simple tendon release in the toe works well. The recovery is rapid often requiring nothing more that a single stitch and a Band-Aid. Of course if several toes are done at the same time, the recovery make take a bit longer. For the surgical correction of a rigid hammertoe, the surgical procedure consists of removing a small section of bone at the level of the rigid joint. The sutures remain in place for approximately ten days. During this period of time it is important to keep the area dry. Most surgeons prefer to leave the bandage in place until the patient's follow-up visit, so there is no need for the patient to change the bandages at home. The patient is returned to a stiff-soled walking shoe in about two weeks. It is important to try and stay off the foot as much as possible during this time. Excessive swelling of the toe is the most common patient complaint.
Complications associated with the surgery include but are not limited to infection, excessive swelling leading to delays in healing and potential deviation of the toe. The toe may be a bit floppy. The toe always has a floppy feeling for several weeks following the surgery. This is normal and generally not permanent.
Angelo Podiatry Associates, P.A.
3162 Appaloosa Cir San Angelo, TX 76901