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How Do You Treat Hammer Toes?

If you have a hammer toe, you may wonder about treatment options. In this article, Dr. Brett Sachs reviews both nonsurgical and surgical treatments.

Hammer toes (including claw toes and mallet toes) can be painful. Depending on the severity (classified as flexible, semi-rigid, and rigid) of your hammer toe, treatments can range from conservative, non-invasive options to surgery. Be sure to consult your doctor to discuss the best treatment plan for you.

Conservative (nonsurgical) treatments

1. Good fitting shoes.  Wearing shoes that have more room in the toe box to accommodate the toe deformity can be beneficial. Conversely, wearing heels and shoes that are too short or have pointy toes can aggravate hammer toe. Extra-depth shoes are also an option.

2. Orthotics and over-the-counter inserts. Shoe inserts and prescription orthotics help provide additional support for the foot and may help correct the muscle/tendon imbalance caused by the hammer toe. These inserts and orthotics may help relieve symptoms and, in some cases, stop progression.

3. Padding and splints. Padding can help relieve the pressure, friction, and pain caused by shoes rubbing against the hammer toe. However, medicated pads can cause skin damage. Hammer toe splints may also help reduce pain and temporarily straighten the toe.

4. Injections. Certain injections may help reduce inflammation and pain from the hammer toe.

5. Physical therapy. Certain exercises may help strengthen the toe joint. Manually stretching the toe a few times per day, and picking up marbles or a towel with the toes may help. Ask your doctor for specific PT recommendations given your personal circumstances.

6. Medication and ice. Anti-inflammatories, pain medicine, and/or ice (used as directed by your doctor) may help reduce the pain, swelling and inflammation of the toe.

Surgical treatments

The goal of these hammer toe surgical options is to reposition the toe and realign the tendons. You should discuss the potential benefits, recovery process, and risks of these procedures with your surgeon (such procedures are performed by an Orthopedic surgeon or Podiatrist).

1. Tendon lengthening. This procedure involves cutting and/or lengthening the contracted tendon causing the hammer toe.

2. Tendon transfer. A tendon transfer realigns the tendon to pull the toe into a straighter position. This can help rebalance the tendons.

3. Joint resection (arthroplasty). A joint resection involves removing a portion of bone to allow for straightening of the toe, a temporary pin (removed after bone healing) can be used to maintain correction of the toe

4. Fusion (arthrodesis). During this procedure, the entire joint is removed in order to straighten the toe. Then, a pin, screw or implant is used to allow the end of the bone to heal and fuse together.

5. Amputation. There are rare cases, typically involving severe deformities, in which removal of the toe may be performed. 

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