Hammer toe deformities are contracted toes that resemble a hammer. It is a contracted deformity of the proximal interphalangeal joint that involves the second, third, fourth, and fifth toes. Mallet toe and claw toe are similar deformities but involve other joints in the toe. The lesser toes have three bones consisting of the proximal phalanx, middle phalanx, and the distal phalanx at the end of the toe. There are two joints within the toe the PIPJ (proximal interphanlangeal joint), the joint closest to the base of the toe and the DIPJ (distal interphalangeal joint), the joint closest to the end of the toe. The hammer toe is a contraction of the PIPJ of the lesser toes causes a bending of the toe that resembles a hammer. Mallet toe is a contraction at the DIPJ. A Claw toe is a combined contraction of the toe at the PIPJ and the DIPJ.
Hammer toe deformities are most commonly the result of wearing poorly fitting shoes that force the toes into a bent position. Shoes that are too short or high heel shoes will cause the bending of the toes. When the toes are bent for a long length of time it causes the muscles in the toes to shorten resulting in contacted toes. Hammer toe deformities are often associated with a bunions. Hammer toe can be caused by neurological issues or trauma. If the hammer toe deformities are not treated, the contracted joints will be exposed to arthritis resulting in the loss of flexibility of the affected toes.
Treatment of hammer toes consist of new shoes with a larger toe box, exercises for the toes, inserts, physical therapy, and custom orthotics. Surgical intervention is necessary when the hammer toe deformity are no longer flexible. There are many different procedures physicians use when correcting a contracted deformity. Implants that remain in the toe are commonly used in the surgical correction of hammer toe surgery.