Hammer, claw, and mallet toes are deformities. The muscles
that control toe movement go out of balance, causing the toe to bend into an
odd position at one or more joints.
A hammer toe occurs when
the longest toe (usually the second toe, next to the big toe) bends down toward
the floor at the middle toe joint. The toe may bend up at the joint where the
toe and foot meet, causing the middle toe joint to be raised
Claw toe often affects all toes
(except the big toe) at the same time, causing them to bend downward at the
middle joints and at the joints nearest the tip, so that the toes curl down
toward the floor. The toes bend up at the joints where the toes and the foot
A mallet toe often affects the second
toe, but it may affect the other toes as well. The toe bends down at the joint
closest to the tip.
These conditions can be painful and uncomfortable,
especially while a person walks, as the toe presses and rubs against the shoe.
These conditions almost always affect the lesser toes (those other than the big
toe), and each condition involves a different toe joint or combination of toe
The conditions are most often caused by tight, poorly
fitting shoes, often in combination with a muscle imbalance. Several muscles
work together to straighten and bend the toes. If a shoe forces a toe to stay
in a bent position for long periods of time, the muscles tighten and the
tendons shorten (contract). This makes it more difficult to straighten the toe.
Eventually, the toe muscles cannot straighten the toe.
treatment, including properly fitting footwear, cushions, shoe inserts, toe
splints, toe stretches, and pain relievers, is often all that is needed to
relieve the discomfort. Hammer toes and mallet toes require surgery only when
nonsurgical treatment fails. Claw toe is more likely to require surgery, but
nonsurgical treatment can be effective. Surgery may not completely return the
toes to their normal positions. And toe joint problems may come back after surgery.
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Gavin W.G. Chalmers, DPM - Podiatry and Podiatric Surgery
How this information was developed to help you make better health decisions.