Hammertoes are one of the most common forefoot deformities. Hammertoes can disrupt normal pressure distribution and gait balance. Those suffering from hammertoe may experience pain, skin breakdown, cosmetic concerns, callus formation, and progressive functional impairment. If your hammertoe is not seen by a doctor right away, surgery may be the only option. However, there are other treatment options if the condition is caught early.
Those with hammertoe may experience gait alterations. Since each patient has unique health issues, hammertoe deformities can range from mild to severe. Some individuals may find relief sooner, especially compared to those who require surgery. While it is not the first course of action to consider, surgery can be useful in correcting hammertoes. In fact, hammertoe deformities can impact a person’s quality of life. Surgical correction of the hammertoe is a common procedure.
Evaluating Hammertoes
Those living with hammertoes may experience pain, constant tenderness, or sensitivity in the area. To accurately evaluate the hammertoes, a doctor may use diagnostic imaging to define the deformity characteristics. Radiographic studies focus on weight-bearing anteroposterior, oblique, and lateral radiographs to assess hammertoe deformities. Imaging allows doctors to measure metatarsal lengths, identify hallux valgus, and assess overall foot alignment.
Another way to evaluate hammertoe is with magnetic resonance imaging (MRI). With an MRI, doctors receive a detailed visualization of the foot. An MRI can reveal cartilage defects and avascular necrosis of the metatarsal head. Those diagnosed with diabetes, peripheral vascular disease, or distal peripheral neuropathy may benefit from noninvasive studies.
Can Hammertoe Be Corrected Without Surgery?
According to the National Library of Medicine, hammertoe deformities arise from multiple congenital and acquired factors. The condition develops from an imbalance between weak intrinsic muscles and stronger extrinsic muscles. Some of the contributing conditions and influences include the following:
- Inflammatory arthropathies
- Diabetes
- Hallux valgus (bunion)
- Long metatarsals
- Ill-fitting shoes and high heels
- Neuromuscular conditions
- Intrinsic muscle imbalance
- Pes planus (flat feet)
The above conditions may contribute to hammertoe. Additional pathologies associated with Hammertoe include Charcot-Marie-Tooth disease, rheumatoid arthritis, and cavus and flat foot deformities.
Development of Hammertoe Deformity
Hammertoe presents with a variety of common concerns including:
- Chronic pain
- Blisters
- Ulcerations
- Hyperextension
- Pressure
The hammertoe deformity has three primary biochemical categories that explain the development of the deformity.
The mechanisms are:
- Flexor stabilization – The most common, this mechanism occurs with excessive pronation of the subtalar joint. In an attempt to stabilize the forefoot, the flexors fire earlier, longer, and more forcefully. This overpowers the interosseous muscles. This happens when the foot rolls inward at the ankle because the muscles that control the foot and ankle are not working evenly on both sides of the leg.”
- Flexor substitution – When the triceps surae is weak, deep and lateral leg muscles attempt to compensate for inadequate plantar flexion. This can result in the flexors gaining a mechanical advantage over the interossei. The calf muscles force the toe flexor tendons to work harder.
- Extensor substitution – Clinically recognizable by bowstringing of the extensor tendons, this mechanism gains a mechanical advantage for the lumbricals, leading to muscle contractions. Muscles become overworked as toes are lifted from the ground. Ankles then fail to clear the ground.
Depending on the severity of your hammertoe, surgery may be required. However, it is possible to correct a hammertoe without surgery by using options your doctor recommends, such as splinting or strapping, injection therapy, or medications.
Find Treatment
At Jamfeet, we offer specialized care for all individuals. Because hammertoe involves many variables, many surgical and non-surgical treatment options are available. If you are suffering from chronic pain, experts can help by suggesting changes such as changing footwear, trimming calluses, or wearing orthotic devices. Medication and injections are also options to consider.
Those with severe cases of hammertoe that require surgery can find an expert surgeon at our podiatry center. Whether you require surgery or not, our doctors can explain your condition. Contact us today to learn more about your treatment options and how your hammertoe can be corrected without surgery.
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