Orthopedics: what is the hammer toe?


It mainly occurs in people with hallux valgus; this condition in fact causes a modification of the natural position of the toes and the forefoot, with the possibility of consecutive appearance of annoying and unsightly dorsal calluses and of a progressive retraction and flexion of the toes.

Causes of hammer toe

The causes that give rise to this disorder are mainly attributable to problems with the “malposition” of the foot, which over time can lead to disorders such as:

  • Plantar Fasciitis
  • Hallux valgus;
  • metatarsalgia due to overload.

This condition can be associated with arthritis, neurological disease, diabetes or trauma, predisposing to strain.

The use of shoes with flat soles, or very high heels and elongated and narrow toes, exposes the foot to additional stress which causes a real imbalance between the muscles of the toe concerned, contributing to the development of the pathology.

It is obvious that there is always a congenital or familial predisposition underlying the formation of this pathology.

Female sex and old age are also risk factors.

The advice I give to my patients is to use shoes with a wide sole and a low heel (2-3cm) to prevent the formation of corns and calluses, which are a wake-up call that causes the formation of corns. hammer toes.

Hammer toe, symptoms

Hammer toe, similar to the claw of a bird of prey, is one of the first manifestations of the disease, accompanied by pain when walking and difficulty flexing the toes.

As already mentioned, calluses appear on the back of the toe affected by this disease, which are formed as a result of the continuous rubbing of the skin against the shoe.

The toes assume an abnormal position, overlapping each other as they are forced into a narrow space.

Walking barefoot, at least indoors, can be of great benefit to people with this condition.

How to avoid hammer toes

Prevention remains the best remedy.

So go ahead:

  • Insoles to be placed inside shoes which must be comfortable and the correct size;
  • exercises to strengthen the muscles of the foot and fingers;

How to treat hammer toe

Traditional physiotherapy can be combined with analgesic laser therapy.

However, conservative treatment is not always successful.

If the deformity becomes chronic, surgery is the only option.


The surgical techniques are diverse and can only involve percutaneous section of the tendon in cases where the deformity has not yet determined significant damage to the joint.

In more advanced clinical cases, in which the proximal interphalangeal joint is compromised and often already ankylotic, a wire arthrodesis resection is performed with contextual correction of the big toe, if necessary.

The surgery can be performed in a day hospital.

Recovery times are relatively short and within days the patient can resume normal daily activities.

We recommend in the post-operative phase

  • anti-inflammatory therapy;
  • antithromboembolic prophylaxis;
  • maintenance of dressings;
  • walk with special shoes.

Clinical assessments and ambulatory dressings are also planned.

About 5 weeks after surgery, a follow-up x-ray is taken and the wire is removed.

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