Hammer toe is a clinical condition in which there is a flexion of the proximal interphalangeal joint and a dorsal hyperextension of the metatarsophalangeal joint and the distal interphalangeal joint that forces the toe to resemble the hammer of a piano key from which its name derives.
The principal cause of hammer toe is an alteration in the muscles and tendon causing the toe to bend. It usually affects the second toe and comes on more often than not with the degeneration and subsequent lesion of the metatarsophalangeal joint capsule which increases instability and the likelihood of developing the deformity. Besides the clearly visible aesthetic defect, these deformities can give rise to inflammation, acute pain and reddening at the point where the foot makes contact with the footwear. The constant rubbing leads to the formation of dorsal or plantar calluses that develop into in ulcerative lesions and infections.
Another cause could be an excessively long toe which is forced to bend because of tight shoes and rubbing.
Occasionally it may be caused by a trauma, a hereditary condition, rheumatic or nervous pathologies or also due to previous surgical operations.
First line therapy consists of correcting the toe deformation before surgical intervention becomes necessary. The use of personalised corrective/protective orthoses will provide the patient with benefits and relief. When the use of comfortable shoes, silicone orthoses or other devices to protect the painful area affected do not remedy the problem, the next option is percutaneous surgery which will cure hammer toe by means of carrying out small osteotomies (the bone is cut to shorten, lengthen or modify its alignment).
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