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Overview
Hammertoes are quite common and may range from mild to severe. A Hammertoe is a contracture, or bending, of one or more toes, usually due to an imbalance between the muscles or tendons on the top and bottom of the toes. Over time, the affected toes lose flexibility, becoming rigid and fixed in a contracted position. The abnormal bend positions the knuckle of the toe upward, causing it to push against the top of the shoe leading to additional problems. The condition usually becomes progressively worse if not treated.

Causes
Medical problems, such as stroke or diabetes that affect the nerves, may also lead to hammertoe. For example, diabetes can result in poor circulation, especially in the feet. As a result, the person may not feel that their toes are bent into unnatural positions. The likelihood of developing hammertoe increases with age and may be affected by gender (more common in women) and toe length; for example, when the second toe is longer than the big toe, hammertoe is more likely to occur. Hammertoe may also be present at birth. Genetics may factor in to developing hammertoe, particularly if the foot is flat or has a high arch, resulting in instability.

Symptoms
A hammer toe may be painful, especially when irritated by a shoe. All four toe conditions may cause cramps in the toes, foot and leg due to the abnormal function of the tendons in the foot. If a mallet toe has occurred, you are likely to suffer from a corn at the end of the toe. A hammertoe may cause a corn on the top of the toe. Infections and ulcers can also occur. In severe cases a mallet toe, trigger toe, claw toe or a hammer toe may create a downward pressure on the foot, which can result in hard skin and corns on the soles of the feet.

Diagnosis
Although hammertoes are readily apparent, to arrive at a diagnosis the foot and ankle surgeon will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, the foot and ankle surgeon may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.

Non Surgical Treatment
The treatment options vary with the type and severity of each hammertoe, although identifying the deformity early in its development is important to avoid surgery. Podiatric medical attention should be sought at the first indication of pain and discomfort because, if left untreated, hammertoes tend to become rigid, making a nonsurgical treatment less of an option. Your podiatric physician will examine and X-ray the affected area and recommend a treatment plan specific to your condition.

Surgical Treatment
If you are unable to flex your toe, surgery is the only option to restore movement. Surgery is used to reposition the toe, remove deformed or injured bone, and realign your tendons. Surgery is normally done on an outpatient basis, so you can return home on the day of your surgery.

Prevention
Preventing foot problems, including hammertoes, is often a matter of wearing the right shoes and taking care of your feet. Check your feet regularly for problems. This is especially true if you have diabetes or any other medical condition that causes poor circulation or numbness in your toes. If you do, check feet daily so that problems can be caught early on.