Hammer toe

Definition
Hammer toe is a deformity of the toe in which the end of the toe is bent downward.

Causes, incidence, and risk factors

Hammer toe usually affects the second toe, although it can 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 can also occur in children who continue to wear shows that they have outgrown.

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)

Signs and tests

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

Treatment

Mild hammer toe and cases 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 accomodate 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 transfering tendons or fusing the joints of the toe together.

Expectations (prognosis)

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

Complications

     
  • foot deformity  
  • posture changes resulting from difficulty in walking

Calling your health care provider

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.

Johns Hopkins patient information

Last revised: December 4, 2012
by Harutyun Medina, M.D.

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