By Asma Khan, DPM
June 26, 2013
Category: Uncategorized
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Hammer toe syndrome


            Hammer toes are one of the most common complaints we see in the foot and ankle specialist’s office.  Hammer toes make shoe gear fitting painful, can lead to ulcerations, and cause patients to be very self-conscious of the appearance of their feet.  They can also make hygiene difficult for older patients. 


            Hammer toes are the visual manifestation of the underlying arthritis at the small joints of the toes.  As the joints become tighter, more contracted, the digits become rigid, deformed, and painful.  While some patients are born with contracted toes, many develop hammer toes over time.  Hammer toes can be due to a hereditary tendency, as well as being caused by poor shoe gear choices, such as tightly fitting dress shoes.  



            Even though hammer toes are a structural problem at the level of the joints, conservative care should always be attempted before considering surgical correction.  Off-loading padding, wearing comfortable shoes with adequate room in the toe box are good options to maintain an active lifestyle without the interruption of post-operative downtime. 


            However, some times conservative management fails to provide adequate relief.  Rather than feeling frustrated, a thorough discussion regarding surgical options and expected outcomes should be undertaken between the patient and his or her surgeon.  Typical hammer toe surgery is referred to as arthroplasty of the digit, and entails removal of the joint followed by a period of splinting or pinning of the affected toe in a straightened position.  As with any surgery, the surgical site and dressing has to be maintained clean and dry until the sutures and/or the pin are removed in the office.  While most patients are back in a regular shoe as soon as any sutures or pins are removed (approximately 4 weeks), every patient is different, and therefore, a return to regular activities and shoe gear is based on when pain and swelling have subsided sufficiently.


            An alternative procedure that may be recommended by the foot and ankle surgeon may be arthrodesis of the affected digit, and this entails removal and fusion of the involved joints.  This procedure is typically required in more advanced and contracted digits, and may take longer to heal. 

            The results of hammer toe surgery can be very gratifying, because patients find that they are able to do the activities that they want to do without the pain and discomfort of their toes rubbing against their shoes.  This leads to a major improvement in the overall health and fitness of the patient.  In this context, hammer toe surgery can be an integral part of maintaining good health and an active lifestyle.