Hammer, claw, and mallet toes
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
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
osteomyelitis, especially if you have
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:
Health Tools help you make wise health decisions or take action to improve your health.
Learning about hammer, claw, and mallet toes:
Living with hammer, claw, and mallet toes:
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise.
The American College of Foot and Ankle Surgeons provides
information on surgery and shoe selection as well as the care and treatment of
heel, toe, ankle, nerve, tendon, nail, and skin conditions. You can also look up and learn about sports injuries, diabetic foot problems, arthritis, and resources in your local area.
The American Orthopaedic Foot and Ankle Society (AOFAS)
provides information on a variety of topics, including foot care for adults,
children, and people who have diabetes; proper shoe fit; and how to select
children's shoes and sports shoes. Some information is available in several
languages besides English.
The American Podiatric Medical Association (APMA)
provides information about foot and ankle injuries, sports-related foot
concerns, surgical and nonsurgical treatment of foot problems, special medical
issues such as diabetes, and resources in your local area. Some information is
available in Spanish.
Other Works Consulted
Krug RJ, et al. (2008). Hammer toe. In WR Frontera et
al., eds., Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation, 2nd ed., pp.
453–456. Philadelphia: Saunders Elsevier.
Maguire S (2008). Mallet toe. In WR Frontera et al.,
eds., Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation, 2nd ed., pp.
457–459. Philadelphia: Saunders Elsevier.
Mann JA, et al. (2006). Foot and ankle surgery. In HB Skinner, ed., Current Diagnosis and Treatment in Orthopedics, 4th ed., pp. 460–534. New York:
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.
Wang D (2008). Claw toe. In WR Frontera et al., eds.,
Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation, 2nd ed., pp.
437–440. Philadelphia: Saunders Elsevier.
June 18, 2013
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
& Gavin W.G. Chalmers, DPM - Podiatry and Podiatric Surgery
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