Toe deformities are common problems that can occur for a variety of
reasons. They may be a congenital problem, the result of an injury, the consequence
of ill-fitting footwear, or the result of diseases that affect the bones and tissues of the
foot. Toe deformities can become a source of pain and discomfort that may lead to
disability as well as more far reaching problems. The most common toe deformities
include hammertoes, mallet toes, and claw toes.
The foot is a complex structure made up of some 28 bones, 30 joints, and
more than one hundred muscles, tendons, and ligaments. These components
facilitate actions that include standing, walking, running, and jumping. The feet help
transmit the body’s weight to the ground and assist in maintaining equilibrium
when in an upright posture.
The toes are part of the forefoot and contribute to the balance and weight
bearing functions of the feet, as well as help to provide thrust when necessary for
efficient walking, running, and related activities. The bones of the toes are known as
The most common toe deformities include:
- Hammertoe: A deformity in which the toe is contracted at the middle joint. It
may occur in any toe with the exception of the big toe
- Mallet Toe: A deformity with a contracture or bending downward of the end
joint of the toe.
- Claw toe: A deformity of the toe where there are multiple contractures. It is
bent upward (extension) at the base of the toe, and bends downward with
contractures at the middle joint and end toe joint.
Although these toe deformities may have developed for different reasons, they
are all progressive. If left untreated or aggravated by footwear they can worsen. Toe
deformities may promote the development of associated problems like corns,
calluses, or bunions, as well as problems for other weight bearing joints such as the
knees and the hips.
The diagnosis of these three common toe deformities can often be made
based on a physical examination of the toes. However, additional tests may be
ordered if nerve involvement or other problems are suspected.
Initial treatment typically involves conservative measures that are directed
towards the relief of pain, the restoration or maintenance of walking ability, easing
pressure and friction, and delaying progression of the deformity. Achieving these
goals may include wearing appropriately designed footwear that provides move
space, cushions and pads for the relief of pressure, splints or tapes to reposition the
toes, and toe stretching exercises.
In cases where the conservative treatment has been unsuccessful in relieving
symptoms, or when the involved toes have become rigid and immovable, surgery
may be recommended. The aim of a surgical procedure is to correct toe alignment
and to restore function.