What is hammer, claw or mallet toe?

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.

• A hammer toe bends down toward the floor at the middle toe joint. This causes the middle toe joint to rise up. It usually affects the second toe. Hammer toes often occur with bunions.
• Claw toe often affects the four smaller toes at the same time. The toes bend up at the joint where the toes and the foot meet. They bend down at the middle joints and at the joints nearest the tip of the toes. This causes the toes to curl down toward the floor.
• A mallet toe bends down at the joint closest to the tip of the toe. It often affects the second toe, but it may happen in the other toes too.

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.

Hammer, claw, and mallet toes may hurt and make it hard to find shoes that fit. They may rub against your footwear and cause calluses or corns. 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:

• When the problems started, what activities or shoes make them worse, and if other parts of the foot are painful.
• What kind of shoes you wear and how much time you spend standing or walking every day.
• Any previous foot problems you have had.
• Any medical conditions you have that could be related, such as arthritis, diabetes, or poor blood flow (circulation).

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 the doctor thinks you may need surgery to correct your problem, you may have tests, such as an X-ray, blood flow testing, or nerve testing.

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 (fixed toe problem). In general, surgery is used only for severe toe problems.

• For fixed toe problems, doctors often do surgery on the bones. One option is removing part of the toe bone. Another is removing part of the joint and letting the toe bones grow together.
• Flexible toe problems are often treated by moving tendons to release tension on the joint. This can let the toe straighten. In some cases, the surgery will still include work on the bones.

Surgery for these problems has not been widely studied, and it may not be for everyone. Talk to your doctor about your options and how much they might help you.

• Have your child wear shoes that have lots of room in the toes.
• Follow your doctor's directions for putting a splint on your child's toe, if your child is given one.
• Gently stretch your child's toe with your fingers.
• Use toe pads or corn cushions to keep your child's toe from rubbing against their shoe. This may keep a corn from forming on the top of the toe.
• Have your child wear a shoe insert, or orthotic, to cushion the bottom of the bent toe.