A hammer toe or in more marked cases called claw foot, is a toe malposition of two to four toes that results from an imbalance of phalanges (toe bones) and soft-tissue. The skeleton of the affected toes is too long in relation to the soft-tissue coating, leading to a, often deforming, protrusion of the middle interphalangeal joint. The malposition causes painful inflammations and also causes problems with shoes.
The cause, as with the ball toe, is the wearing of wrong shoes. High-heeled, pointed shoes lead to a shortening of the flexor tendon and also to a conglutination of the joint capsule, causing the typical toe malposition. A splayfoot furthers the exaggerated flexed position. Also neurological or muscular diseases can cause the development of a hammer toe.
Depending of the stage of deformity an improvement may be achieved with orthopaedic inlays. Lasting results can only be obtained by an operation. In some cases a soft-tissue correction is sufficient, however in most cases a straightening of the bone is necessary. To preserve the middle phalangeal joint the basic joint is shortened to match it with the shrunk soft-tissue coating. Afterwards the toe can be stretched and the normal foot position is regained. The middle phalangeal joint is fully functional and inflammation subsides.
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