Hammertoe In Diabetics: How Surgery Can Help

Diabetes is a complex condition that can affect many different parts of the body, but the feet and toes are particularly vulnerable to diabetes-induced problems. Many people with type I or type II suffer from hammertoe, a debilitating toe deformity that can seriously affect your mobility and quality of life. 

How Does Diabetes Cause Hammertoe?

Each of your toes contains two joints, similar to the joints in your thumbs, which allow the toe to bend at its base and at the toe's halfway point. Hammertoe occurs when the joint at the halfway point of a toe no longer functions properly. This causes the toe to bend permanently downwards, giving it the hammer-like appearance that the condition is named after.

Hammertoe can be caused by a number of different underlying factors, such as genetic susceptibility, improper footwear, or fibrosis caused by a traumatic toe injury. Chronic illnesses that affect the nerves in the toes are a common trigger for the development of hammertoe, making diabetic people especially vulnerable.

Many diabetic people suffer from diabetic neuropathy, which occurs when high blood sugar levels cause damage to the nerves in the body's extremities. The toes are often the first parts of the body to be affected by diabetic neuropathy. 

When diabetic neuropathy causes significant damage to the nerves in the toes, the ligaments and tendons that control the toes stop receiving signals from the brain and nervous system. With no nervous signals compelling them to move, the ligaments and tendons start to shrink and atrophy. Because these ligaments and tendons are located underneath the toe, they pull the end of the affected toe(s) downward as they shrink. Over time, the toe can become permanently locked in this bent position, creating a severe case of hammertoe.

How Can Surgery Correct Hammertoe In Diabetic People?

If you suffer from diabetes, and one or more of your toes are suffering from what appears to be a hammertoe, you should visit a podiatrist as soon as possible. Getting a professional diagnosis is essential, as a number of other musculoskeletal conditions can cause similar symptoms to hammertoe, and must be ruled out before treatment can commence.

If you are suffering from hammertoe as a result of your diabetes, your podiatrist can offer a range of conservative treatments designed to minimize pain and maximize mobility. Specially designed prescription shoes, shoe inserts, and toe padding can help reduce pain and callusing in the afflicted toe(s). Corticosteroid injections can also help relieve pain.

However, if your hammertoe is seriously affecting your mobility, and/or continues causing severe pain despite conservative treatments, surgery may become necessary. Different surgical procedures can be performed to correct a hammertoe, depending on the severity of the condition. Most of these surgeries are minimally invasive and can be performed as outpatient procedures, so you won't have to stay in the hospital overnight.

If your hammertoe retains a small amount of flexibility, your surgeon may perform a tendon transfer. During this procedure, the surgeon moves the tendons underneath your toe to a new position at the top of the toe. Because this tendon pulls your toe down when it contracts, moving it to the top of the toe reverses the effect, allowing the toe to straighten out and restoring some of its mobility.

However, because diabetic neuropathy causes shrinkage and atrophy in the toe tendons, tendon transfer may not be suitable for many diabetic patients. In these cases, the surgeon will cut the shrunken tendons to stop them from pulling and contracting the toe and insert pins into the toe bone to maintain its strength and stability. These pins can be removed once the toe has healed from surgery, usually within a few weeks.

Contact a local podiatrist to learn more about hammertoe surgery.