A hammer toe is also known as a claw toe deformity, and is caused by changes in strength of the small muscles in the foot, worsened by tight fitting and high heel shoes. The development of a bunion may also lead to a hammer toe deformity. The non-operative treatment is to wear a slightly wider and roomier shoe, and use soft pads to prevent rubbing on the top of the toe under the shoe.
If non-operative measures fail to alleviate the problem then surgery can be considered. Surgical correction of the deformity is usually a day case procedure and is performed under a local anaesthetic ankle block with intravenous sedation. The surgery involves removal of the prominent knuckle of the toe, rebalancing of the tendons of the toe and the placement of a wire down the middle of the toe to hold the position of correction. The wire is simply removed in the clinic usually 4 - 6 weeks following surgery. If present an associated bunion will also usually need to be corrected at the same time.
Case - 1 Arthrodesis
Pre-operative photograph of a patient who presented with a symptomatic bunion. The patient reported pain in the region of the bunion while wearing shoes.
Pre-operative x-ray of the same foot.
Post-operative photograph six weeks following surgical correction of the big and second toe. Note that the bony prominence of the bunion is now gone
Post-operative x-ray. The deformity has been straightened by firstly cutting and then repositioning the first metatarsal bone. The corrected position has been held with three screws.
