Toe deformity

These deformities affect the lesser toes (2nd, 3rd, 4th, 5th toes) in the foot and look as if the toes are bent.

The different names correspond with different joints in the toes being affected. Hammer and mallet toes look like the namesake – hammers and mallets. A claw toe is the complete curling of the toe joints.

These deformities may be flexible or rigid. It is important to understand the difference. A flexible deformity is caused by abnormal muscle contracture. If you can imagine a pully system made of muscles attaching to the bones on the top and bottom of your toes. If you pull one side it will move. This pully system is actually your muscles and if one side is too tight or pulling too hard, it will cause the toes to bend (flex). Pressing the toes down and seeing if they straighten can test this. If they do, it is a flexible toe deformity. If they don’t straighten you will have a rigid toe deformity, which is caused by the bones in the toe being fused together in a bent position. Callus can develop on the tips of the toes or on the ball of the foot.

How is it treated?

Management is similar to bunions, with appropriate footwear (wide and deep toe box). Similarly your podiatrist may give you a toe prop to place under the toes and take the pressure off the tips. Any severe callus should be debrided by a podiatrist. For a flexible clawing deformity, orthotic therapy with forefoot padding can help reduce the degree of bending in the digits. Long-term resolution is surgery to straighten the toe out again.