The lesser toes can become bent at any of the small joints, rubbing on shoes. A hammer toe is bent at the near joint while a mallet toe is bent at the far joint. Initially you will be able to stretch out the toe but later it will become fixed in the bent position.

Causes

The hammer toe is due to an imbalance of the small muscles that hold a toe in position. It may start initially after an injury or be associated with tight shoes or inflammatory arthropathy. Eventually the toe is pulled out of joint (“a claw toe”) which can cause pain under the metatarsal head.

Treatment

Shoes need to be wide and spacious around the toes. Shoes should be one 1cm longer than your longest toe. You should try your own toe stretches. Local pharmacists or an orthotist may provide a choice of straps, cushions or pads to relieve the symptoms.

Surgery

Hammer toe can be corrected by day case surgery. The actual procedure will depend on the type and extent of the deformity. The traditional treatment involves a metal wire protruding through the tip of the toe for six weeks. This must be kept clean every day. However the Cotswold Foot and Ankle Clinic now offers an easier option for the patient using an absorbable pin which is entirely within the toe. Our results at one year show this is as good at correcting the toe as the traditional technique.