Hammertoe

Toe deformities are unsightly, painful, and can even be embarrassing. Further, deformities like bunions, hammertoe, and related conditions tend to be progressive in nature. This means they will continue to worsen over time when left untreated, and can only be completely corrected with surgical intervention. Fortunately, there are conservative (nonsurgical) options that can halt progression and relieve symptoms.

If you observe any wayward or abnormally-curled toes, contact South Hill Foot & Ankle Clinic at your earliest opportunity. Dr. Borys Markewych is experienced and skilled in both conservative and surgical treatment for hammertoe and related conditions.

Borys Markewych DPM

Hammertoe and Related Toe Deformities

Whereas bunions result in toes that become displaced on a horizontal plane, hammertoe, mallet toes, and claw toes are conditions wherein affected toes bend abnormally at various joints (depending on the particular condition).

To help you understand which particular issue you are experiencing, let’s take a look at these respective deformities:

  • Hammertoe – In this case, an affected toe is bent downward at the middle joint and the front portion points down, towards the ground. A hammertoe condition is most commonly experienced in the second toe (right next to the big toe).
  • Mallet Toes – This condition is similar to hammertoe, in the facts that there is a single, downward bend in the toe. The key distinction is that instead of happening at the middle joint, the abnormal bend is in the joint closest to the tip of the toe. As with hammertoe, this is most often seen in the second toe.
  • Claw Toes – Whereas the other two conditions affect only a single toe at a time, claw toes typically—but not always—affects all of the smaller four toes. Another key distinction is that claw toes present with more than one abnormal bend. In addition to downward bending at both the middle and top toe joints, there is also an upwards bend at the metatarsophalangeal (MTP) joint – which is where the toe connects to the foot).

Causes and Symptoms

Put simply, these toe deformities develop in response to an imbalance in strength between the muscles and connective tissues found on the tops and bottoms of toes. A weaker muscle or tendon on the top of the toe, will cause the toe to bend downward.

There is some misconception that hammertoe is caused by ill-fitting shoes, and especially women’s high heels. The logic behind this is fairly reasonable, but it isn’t entirely correct. A pair of shoes that places excessive pressure in the front area is more likely to exacerbate an existing problem, rather than create one in the first place. Of course, if you are concerned about potential issues from footwear, you should simply stop by The Walk Shoppe – our boutique shop offering shoes that are both functional and stylish.

The obvious symptoms of hammertoe, mallet toes, and claw toes are toes that do not lie straight, as they naturally should. Beyond appearance, you may experience discomfort and pain, and have an increased risk of corns and calluses. (The Walk Shoppe offers footwear that can reduce that risk.)

Diagnosis and Treatment Options

Dr. Markewych will start by evaluating your lower limbs, which may include ordering x-rays. After assessing the full nature of your condition, Dr. Markewych will begin developing an appropriate treatment plan.

If your condition is in the early stages of development, conservative techniques might be effective. Options like orthotics or pads and changing footwear can place your toes into a better position, thereby relieving painful symptoms. Orthotic devices may also be used to redistribute pressure off of specific areas. In the very early stages, exercises to stretch and strengthen toe muscles might be beneficial.

Hopefully conservative options can relieve your pain, improve mobility, and prevent the condition from becoming more severe. There are certainly cases, though, where the condition has progressed too far and surgical intervention is required. The good news in this instance is the fact Dr. Markewych performs many procedures using minimally-invasive techniques.

Minimally-invasive surgeries have numerous benefits over traditional procedures. These benefits include smaller incision sites, faster healing, and no need for a hospital stay. These surgeries are performed under Fluoroscopic imaging, which is less invasive – helping to reduce pain and complications, and quicken recovery. A compression digital dressing is used immediately after surgery to sterilize the toe; therefore, no pins or orthopedic hardware is used and no toe joint is fused. Postoperative patients are placed in a surgical shoe to aid with walking and the patient will walk out of the operative room immediately.

In traditional surgery, range of motion is limited or absent due to the fusion of the joints. This involves longer incisions for repositioning the bones of the contracted digit or taking out the joint to straighten the toe which would require pins or other surgical hardware to sterilize the healing toe.

Your specific procedure will depend, naturally, on your situation. Dr. Markewych may determine that the best way to correct the deformity is to release a tight tendon causing the toe to bend or remove pieces of bone so the toe can lie flat. No matter the procedure, we will discuss it together so you can understand what to expect.

If you have hammertoes, claw toes, or mallet toes, make an appointment today with South Hill Foot & Ankle Clinic to get the help you need. We are conveniently located in Spokane and provide comprehensive foot care services for our patients. Call us at (509) 747-0274 or use our online form to connect with us today.

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