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Hammer, claw, and mallet toes
are toes that are bent into an odd position. They may look strange or may hurt, or both. These toe problems almost always happen in the four smaller toes, not the big toe.
If you notice that your toe looks odd or hurts, talk to your doctor. You may be able to fix your toe with home treatment. If you don't treat the problem right away, you are more likely to need surgery.
Tight shoes are the most common cause of these toe problems. Wearing tight shoes can cause the toe muscles to get out of balance. If a shoe forces a toe to stay in a bent position for too long, the muscles tighten and the tendons shorten, or contract. This makes it harder to straighten the toe. Over time, the toe muscles can't straighten the toe, even when you aren't wearing shoes.
These toe problems form over years and are common in adults. Women are affected more often than men because they are more likely to wear shoes with narrow toes or high heels.
Less often, these toe problems are linked with other conditions, such as diabetes, rheumatoid arthritis, stroke, or an injury to the foot or ankle.
Besides looking odd, hammer, claw, and mallet toes may:
In more severe cases, these toe problems may affect your balance and make it hard to walk.
Your doctor will ask questions about your symptoms and past health and do a physical exam. Your doctor will want to know:
During the physical exam, your doctor will look at your foot to see if the toe joint is fixed or flexible. A joint that has some movement can sometimes be straightened without surgery. A fixed joint often requires surgery.
If you are thinking about having surgery to correct your problem, you may need:
You can probably treat your toe joint problem at home. If you start right away, you may be able to avoid surgery.
If your toe joint is flexible, you can also try:
Call your doctor if your pain doesn't go away or it gets worse after 2 to 3 weeks of home treatment, or if you get a sore on your affected toe. Sores can get infected and lead to cellulitis or osteomyelitis, especially if you have diabetes or peripheral arterial disease.
In general, surgery is used only for severe toe problems. You may need surgery if other treatments don't control your pain, if your toe limits activity, or if you can't move the toe joint.
For fixed toe problems, doctors often do surgery on the bones. Doctors can often treat flexible toe problems by moving tendons to release tension on the joint and let the toe straighten. In some cases, the surgery for a flexible toe problem will still include work on the bones.
Your options may include one or more of the following:
Surgery for these problems has not been widely studied and may not be for everyone. Talk to your doctor about the types of surgery and how much they might help you.
When thinking about surgery, keep in mind that:
Other Works Consulted
Lirofonis VA, Scardina RJ (2015). Mallet toe. In WR Frontera et al., eds., Essentials of Physical Medicine and Rehabilitation, 3rd ed., pp. 452-454. Philadelphia: Saunders.
Mann JA, et al. (2014). Foot and ankle surgery. In HB Skinner, PJ McMahon, eds., Current Diagnosis and Treatment in Orthopedics, 5th ed., pp. 384-455. New York: McGraw-Hill.
Montero DP (2015). Hammer Toe. In WR Frontera et al., eds., Essentials of Physical Medicine and Rehabilitation, 3rd ed., pp. 448-451. Philadelphia: Saunders.
Thomas JL, et al. (2009). Clinical practice guideline: Diagnosis and treatment of forefoot disorders. Section 1: Digital deformities. Journal of Foot and Ankle Surgery, 48(2): 230-238.
ByHealthwise StaffPrimary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency MedicineAdam Husney, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family MedicineSpecialist Medical ReviewerGavin W. G. Chalmers, DPM, FACFAS - Podiatry and Podiatric Surgery
Current as ofNovember 29, 2017
Current as of:
November 29, 2017
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& Adam Husney, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine & Gavin W. G. Chalmers, DPM, FACFAS - Podiatry and Podiatric Surgery
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