Technical Name:
Lesser toe deformities
AKA Name:
Hammer toe, claw toe and mallet toe
Short Summary:
Lesser toe (all toes except big toe) deformities are relatively common and can cause significant pain and discomfort for the individual.
Hammer toe deformity relates to the joint in the middle of the toe pointing upwards with the end part flexing to the floor.
This means that the joint becomes prominent in footwear and rubs causing irritation and pain.
Mallet toe deformity relates to the joint at the tip of the toe that flexes downwards causing a similar irritation.
Claw toe is a combination of deformity at the joint at the base of the toe in combination with the two joints in the toe itself resulting in part of the toe sticking up and rubbing on footwear.
All of these deformities if they persist can result in corns or ulcers forming on the toes.
What are the symptoms?
As described above the deformities all can cause pain when wearing tight or narrow fitting footwear and this is worsened with any form of activity.
Patients sometimes complain of the sensation of walking on a pebble if the deformities are significant.
With time ulcers or hard areas of skin can develop.
How is it diagnosed?
Diagnosis is made form a clear and comprehensive medical history including any possible genetic factors, neurological cause or any form of inflammatory arthritis such as rheumatoid.
How is it treated?
Non-operative treatment
The first line of treatment is often over the counter simple soft tissue pads or supports for the toes to cushion any excessive pressure from footwear. Modification of footwear from narrow to more spacious wider fitting shoes can be beneficial.
Operative treatment
If non-operative measures fail or the deformity has worsened then surgery may be the option. The precise nature of the surgery depends on where and the extent of the deformity of the toe but essentially involves straightening the toe and stiffening it in this position.