Claw, Hammer & Mallet Toes

Claw, Hammer and Mallet toes all involve a degree of contracture (stiffness and “deformity”) of the joints of the involved toe.

The cause is not always clear. It may result from dysfunction of the small muscles of the foot, an associated deformity of the great toe (eg crowding with bunion deformity), by forcing the toes into shoes which are too small, trauma or hereditary factors.

The joints involved become prominent and rub. Friction between the shoe and a bony prominence causes the skin to thicken and form a corn or a callosity (occasionally even an ulcer) on the top of the toe or at its tip. The corn, not the deformity, is often the most troublesome problem.

Occasionally the affected toe under- or over-lies its partner.

Sometimes the bony prominences of toes simply become prominent rather than the joints being contracted. They may rub on each other or the shoe to cause a callous.

When toes rub together, the skin often macerates and causes an extremely painful (and obscure) “soft corn” or ulcer.

Operative intervention may be needed particularly if there is recurrent ulceration or infection.

Great toe deformity correction is frequently needed to reduce both crowding and stress.