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 Problems
with Your Little Toes
Your little toes help to balance and propel your body when you move.
As your foot flattens, the little toes bend to grip the ground.
Then they straighten, acting like levers to help push your foot
so you can walk, run, or dance. But if the front of your foot is
wide, you may develop a problem known as a hammer toe. Hammer toes
are little toes that buckle or curl under. Over time, these toes
may hurt and make movement more difficult. But you don’t have
to live with pain. With your doctor’s help, even severe hammer
toes can usually be treated so you can move more easily.
What are Hammer
Toes?
 In
general, the term “hammer toe” describes a buckling of
any of the toe joints. Joints at the end or middle of the toe, as
well as the joint near the ball of the foot, may be affected. Toe
joints usually curl because of a muscle imbalance or tight tendons.
Hammer toes vary in severity and in the number of joints and toes
involved.
Physical Exam
Your doctor will examine all your toes, testing whether or not buckled
joints can be moved. Your feet will also be checked for any skin
changes. Corns (a buildup of dead skin cells) often form between
curled toes or on top of buckled joints where shoes rub. If irritated,
corns may turn into open wounds and become infected.
Testing
X-rays may be taken of a curled toe to show the amount of deformity.
An x-ray may also show whether or not the joint is affected by arthritis.
Types of Hammer
Toes
Hammer toes may be flexible or rigid, depending on the joint’s
ability to move. A flexible joint may become more rigid as you age.
  A
Flexible Joint
You can straighten a flexible hammer toe with your fingers. Although
they look painful, flexible hammer toes may not hurt.
A Rigid Joint
A rigid hammer toe cannot be moved, even with the fingers. Rigid
joints may cause pain and distort foot movement. This may put extra
stress on the ball of the foot, causing a callus (a corn on the
bottom of the foot).
Treating Hammer
Toes
If your symptoms are mild, changing shoes may be all the treatment
you need. Using a splint or pad to hold your toes straight also
may help. Or try cushioning corns and calluses with felt padding.
If your symptoms are severe, surgery may be needed. The type of
procedure often depends on whether your toe joints are flexible
or rigid.
Flexible Joints
To release a buckled joint, the tight tendon (often the bottom one)
is cut and repositioned.
Rigid Joints
A piece of bone may be removed to help straighten a rigid toe. Two
surgical examples are shown below. With either surgery, a pin may
be used to hold the remaining bone in position during healing.
After Surgery
Almost all hammer toe surgeries are out-patient procedures. In fact,
you may even be able to bear weight on your foot by the time you
go home. For best results, however, you may need to wear a surgical
shoe for several weeks.
The First Few Weeks
Your foot will be bandaged after surgery, and you may need to wear
a surgical shoe to support the foot during healing. Your doctor
may recommend a special dressing to limit swelling. Elevation and
ice can also help. For best results, raise your foot above heart
level and apply ice for 15 to 20 minutes. Protect your skin by placing
a towel between the ice pack and your skin.
Proper Shoes
Help make surgery a success by wearing shoes that fit your feet.
Shoes should be long enough and wide enough to keep all your toes
comfortable.
This information is not intended as a substitute
for professional health care.
©1995, 1999 The StayWell Company
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