Common Foot and Ankle Problems & Treatments
Hammertoe Deformities

General Information

Hammer toe, mallet toe and claw toe are all deformities describing bending or clawing of the toes. They appear somewhat similar, but have subtle differences, hence the different names.

With hammer toe, the affected toes give the appearance of a hammer. Differences between hammer toe, claw toe and mallet toe are determined by the direction and extent of the deviations in the joints of the toe or toes affected.

With hammer toe, the middle joint of the toe is affected.

The effects of hammer toe

The effect of the condition is a tightening of the ligaments and tendons of the toe, causing a buckling of the joint of the toe.

The result is a cocking of the toe upward, whereas on a normal foot the toes lie flat.

Shoes can then rub on the top of the cocked toe, eventually causing painful corns or calluses.

If the deformities are not treated early enough, the toe may become permanently fixed and rigid.

Symptoms of hammer toe

There will be an obvious hammer-shaped deformity of the affected toe, in addition to pain and a callus caused by the upper part of the toe rubbing against the shoe.

A corn or callus may also develop on the tip of the toe from pressure and rubbing on the bottom of the shoe.

Sufferers may find it difficult to find shoes that do not cause pain, and infections may develop as a result.

Ulcers may develop in sufferers with diabetes, because of decreased sensitivity in the foot.

What causes hammer toe?

The main cause of hammer toe deformities is genetics.

Symptoms can be caused, however, by wearing tight shoes or high heels that crowd the toes.

Hammer toe may also be brought on by injury or by bunions pushing the big toe against the smaller toes.


How can hammer toe be treated?

If the hammer toe condition has become rigid (inflexible, fixed, permanent), surgery may be required, with a goal of realigning the toe. Procedures may include:

  • Cutting or lengthening tendons.
  • Transferring a tendon to another place.
  • Shaving a small piece of bone from the prominent knuckle.
  • Insertion of a steel pin to fix the corrected position of the toe.

If surgery is necessary, a period of several weeks in an open-toed surgical shoe that acts like a splint will probably be required.

Surgery can be done under local anesthesia, with just one needle, in our out-patient ambulatory center. If desired, IV sedation can be given for those who do not wish to be aware that anything is being done. In either case, you are usually on your way home 25 to 30 minutes after the procedure.

How can I relieve the symptoms of hammer toe?

The symptoms of hammer toe and the other related conditions of mallet toe and claw toe can be relieved with conservative measures, if treated early enough, before the abnormal position becomes rigidly fixed. Try these methods:

  • Wear shoes with soft and roomy toe boxes (at least ½ inch longer than the longest toe).
  • Avoid wearing high heels.
  • Stretch the upper part of the shoe to accommodate a fixed hammer toe.
  • Strengthen toe muscles with exercises, such as picking up marbles with the toes, and stretching exercises.
  • Wear orthotics.
  • Wear soft pads over the corns or calluses.
  • Shave off thickened skin with a pumice stone or file.