Hammertoe Treatment

What Is a Hammertoe?

A hammertoe is a progressive deformity in which one or more of the smaller toes — most commonly the second, third, or fourth — bends abnormally downward at the proximal interphalangeal joint, the middle joint of the toe. The toe takes on a claw-like appearance that worsens over time without intervention.

Hammertoes develop when the balance between the muscles and tendons controlling the toe is disrupted — typically by an underlying biomechanical issue such as flat feet, bunions, or an abnormally long second metatarsal. Footwear that crowds or compresses the toes accelerates the progression of a deformity that is already developing.

In the early stages, a hammertoe is flexible — the toe can still be straightened manually, though it returns to the bent position when released. At this stage, conservative measures are most effective at slowing progression and managing symptoms. As the deformity advances and the joint contracture becomes fixed, the toe can no longer be straightened passively and surgical correction becomes the only option for restoring alignment.

The most common symptoms are pain on top of the bent joint from shoe pressure, corns over the prominence, calluses on the ball of the foot beneath the affected metatarsal head, and difficulty finding footwear that accommodates the deformity. In advanced cases, the toe may cross over or under an adjacent toe.

Hammertoes frequently occur alongside bunions — the bunion shifts the big toe toward the second toe, which in turn crowds and deforms the lesser toes. When both conditions are present, Dr. Gunter evaluates and addresses them together rather than treating each in isolation.