Hammer Toes

A 58-year-old woman presents complaining of her second right toe becoming more crooked. She states that it is bending more often and that she has a callus developing over the second toe. She no longer wears pointed-toe shoes, as they are unable to accommodate for her toe deformity. Even with a deeper toe box, the patient continues to have a worsening deformity of the second toe.

CLINICAL PRESENTATION

People with hammer toe may have corns or calluses on the top of the middle joint of the toe or on the tip of the toe. They may also feel pain in their toes or feet and have difficulty finding comfortable shoes. As a group, these deformities can be secondary to overcrowding in closed-toe shoes that are too small for the foot, a muscle imbalance, or a combination of one or more other factors.

PHYSICAL FINDINGS

A hammer toe exists when there is a flexion deformity of the proximal interphalangeal (PIP) joint. A mallet toe exists when there is a flexion deformity of the distal interphalangeal joint (DIP). When either the DIP or PIP joint is involved with the metatarsophalangeal (MTP) joint, the diagnosis is claw toe.

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