Toe Deformities

The three most common toe deformities are Claw Toe, Hammer Toe, and Mallet Toe.

Claw toes are named because of the abnormal appearance of the affected foot. The condition involves a deformity in which the toe joint nearest to the ankle bends upward and the other toe bends downward in a fixed contracture. Claw toe can cause pain, result in the development of other disorders, or be a sign of a more serious underlying condition.

A hammer toe is an abnormally crooked, contracted toe that takes the shape of an inverted “V.” This condition develops when a muscle or tendon imbalance causes the toe to buckle and eventually become stuck in a bent position. Hammer toes may occur for a number of reasons, including hereditary abnormalities, rheumatoid arthritis, traumatic injury, or wearing poorly fitted shoes.

Treatment depends on the severity of the condition, but simple measures like wearing roomier shoes, custom orthotics, or taking anti-inflammatory medication to relieve pain may provide relief. Certain exercises to stretch and strengthen the feet and toes may be helpful. Toes may also be taped to correct their position and sometimes corticosteroid injections are administered to alleviate swelling and pain. Only when claw toes or hammer toes are severe is surgery recommended.

Mallet toe is a painful condition in which the top joint of the toe bends abnormally, creating the appearance of a mallet and making it difficult to walk. It is similar in causes, symptoms and treatment to the more common condition of hammertoe which affects the next lower joint. Mallet toe may develop due to hereditary abnormalities, rheumatoid arthritis, traumatic injury, or the wearing of poorly fitted or high-heeled shoes. In addition to pain, patients may experience redness and swelling and the development of a corn or callus on the affected toe. Effective treatment for mallet toe can usually be achieved through simple nonsurgical techniques such as:

• Wearing more comfortable shoes and avoiding high heels
• Doing exercises to straighten and strengthen the affected toe
• Wearing custom-made orthotics or padded inserts in the shoes
• Taping the affected toe to improve its position
• Taking oral anti-inflammatory medication
• Receiving corticosteroid injections at the site

Severe cases in which the toe becomes rigid and tight may require surgical correction to provide symptom relief. When necessary, such surgery may be performed one of three ways:

1. Removing a small section of bone from the affected joint (arthroplasty)
2. Releasing the tendon that is keeping the toe from lying flat (tendon release)
3. Fusing the bones of the affected joint to keep the toe straight. Fusion surgery requires the use of a metal pin to hold the toe in position as it heals.