PM&R Board Review

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. 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. As long as hammer toe causes no pain or any change in your walking or running gait, it isn’t harmful and doesn't require treatment. Seek medical attention if the toe becomes painful and you have difficulty walking. The condition is usually irreversible, but often its progression can be slowed or halted. Rheumatoid arthritis and pressure from a bunion are some of the risk factors for hammer toe. Home Remedies for Hammer Toe The key to prevention is to wear shoes that fit you properly and provide plenty of room for your toes. Here’s how to get the right fit. Surgical treatment of toe deformities may be recommended by your physician if conservative treatment measures fail to relieve your symptoms or if the toes are in a rigid, fixed and immovable position. Surgery to correct toe deformities is performed in a hospital operating room under local anesthesia with regional pain blocks and usually does not require an overnight hospital stay. If some flexibility exists in the toe, your surgeon will make an incision over the deformed toe joint and realign the tendons and ligaments. Pins may be placed to keep the toe in position while healing. The incision will then be closed with sutures and covered with a sterile dressing. You can see the second toe slightly bent forward in the middle. It looks like a claw or a hook protruding from the toe. Initially it would be easy to move the toe to straighten it. But as time passes, it is not possible to straighten it. Sometimes, a callus is seen on the sole of the foot. The most important thing to do if you are concerned is to see your doctor, they will be able to refer you to a specialist if one is required. High arches and flat feet can eventually cause the joint changes. Wearing shoes with no arch support can eventually cause the problems, too.mallet toe causes Bunions and hammer toes are the bread and butter of a podiatrist. They keep on coming into my office like coughs or upper respiratory infections keep coming into a family doctor's office. I have seen large, small, deformed, gross, tiny, under corrected and over corrected hammer toes and bunions. I have never seen a cute one though. Sometimes I even dream about bunions and hammer toes at night (sad but true). It is very common that I see these two foot problems together. If surgery is required, a period of several weeks in an open-toed surgical shoe that acts like a splint will probably be needed. Living With Mallet Toe? Any change to one part of the foot significantly affects habitual ways of walking and standing. Left untreated, foot ailments such as claw toe, hammer toe, or mallet toe may produce problems in other weight-bearing joints, such as the hips or knees. Any forefoot problems causing pain or discomfort should be given prompt attention. People who experience problems with their feet should seek advice from an experienced physician or podiatrist who can evaluate the risks, benefits, and possible complications of various treatment options. Patient compliance is particularly important in the treatment of these conditions. Mallet Toe is a form of deformity in the foot. This happens when the joint nearest to the toe gets bent and creates an arch. The arch will be extra ordinary shape and highly irregular. Research has been done to find out why this happens. All pointers lead to heredity as the main reason. General weakness of the body including the nervous system and bones is the reason for the affliction setting in. Lack of muscle coordination is also another reason. If the injury was severe, the patient requires surgery to modify the joint. And surgery may include cutting the tendons, tendon transfer, or merge the finger joints together. A mallet toe deformity is basically a hammertoe deformity occurring at the most distal (end) joint on the toe. The end of the toe becomes bent downward in a rigid fashion and cannot be bent upwards (straightened). The head of the middle phalanx (middle bone in toe) becomes more pronounced and enlarged over time primarily from shoe irritation. The end result is a painful corn over the bone and in many cases an accompanying bursitis. In many instances the corn may become infected depending on a number of factors including degree of deformity, type of shoe worn, patients age and quality of circulation coming in to the toe. Treatments for hammertoe involve how flexible the toes is. Your podiatrist will definitely tell you which shoes are better, and to stay away from shoes that hurt your foot. Orthotics or shoe inserts will help the toe to get back into the right place where it is supposed to be, and will take away the pressure, which should provide you with pain relief. Pumps, athletic shoes, and sandals that have straps are the better types of footwear. These shoe types will allow your feet breathing space unlike other types such as plastic shoes.