Hammer toe (hammertoe) syndrome, or flexion contracture of the toe, occurs when a toe stays in a curled or flexed position. It can be caused by a muscle imbalance, arthritis, nerve damage (often coinciding with medical problems like a stroke or diabetes), or shoes that do not fit well. Hammer toes most frequently involve the second toe, though they can develop on any toe, and multiple toes.
With "flexible" hammer toe, the affected toes are still moveable at the joint and can sometimes still be straightened. "Rigid" hammer toe is more serious, as the tendons tighten and the joints become misaligned and immobile. Non-surgical options include splinting or taping the toe into its normal position, the use of padding to minimize pressure on the toe when walking, wearing custom shoe inserts or shoes that are more roomy at the toe, and the use of anti-inflammatory drugs and cortisone injections. Orthotics and toe strengthening exercises may also be used to relieve pain.
Hammer toe repair surgery is recommended when there is severe pain in the toe that hinders daily activities and non-surgical remedies have not helped, if corns and calluses arise as a result (causing additional discomfort), if the patient has trouble walking or finding comfortable shoes, or the malady causes a severely deformed foot. Several kinds of surgery can be performed, depending on the condition of the toe. Options include realigning tendons to reposition the toe, cutting or transplanting toe tendons, removing parts of the toe bones, fastening the bones with pins, and fusing the joint together to prevent the toe from bending.
Hammer toe repair is usually an outpatient procedure done under local or regional anesthesia. After surgery, surgical pins or a wire (Kirschner or K-wire) may remain to hold the toe bones in place while the toe heals. Full recovery typically takes one to three months, and largely depends on which toe was operated on