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Hammertoe and mallet toe


Hammertoe Deformity - Hammertoe deformity is the most common deformity of the lesser toes. It primarily comprises flexion deformity of the proximal interphalangeal (PIP) joint of the toe with hyperextension of the metatarsophalangeal (MTP) and distal interphalangeal (DIP) joints.

A hammertoe is a toe that's curled due to a bend in the middle joint of a toe. When you think of a hammertoe, it's common to picture shoes that are too short or heels that are too high. Under these conditions, your toe may be forced against the front of your shoe, resulting in an unnatural bending of your toe.

When hammertoe occurs, your toe may press against the top of the toe box of your shoe, causing pain and pressure. In addition, you may have pain from a hard growth of skin (corn) on the top of your toe that can form where your toe rubs against your shoe. Pain may also result from calluses that develop under the tip of your toe or on the ball of your foot.


Unlike a bunion, which affects only your big toe, hammertoe can affect any toe. Most commonly, it occurs in your second toe. Generally, both joints of the toe are affected, causing your toe to bend upward in the middle, giving it a hammer-like or claw-like appearance. The differences between hammertoe and mallet toe are subtle. A mallet toe has a deformity at the end of the toe that gives the toe a mallet-like appearance.

Aside from wearing crowded shoes, hammertoe and mallet toe may result from muscle and nerve damage caused by diabetes. Relieving the pain and pressure may involve changing footwear and wearing shoe inserts. In more severe cases, you may need surgery.

Signs and symptoms 

Signs and symptoms of hammertoe and mallet toe may include:

  • A hammer-like or claw-like appearance of a toe

  • In mallet toe, a deformity at the end of the toe, giving the toe a mallet-like appearance

  • Pain and difficulty moving the toe

  • Corns and calluses resulting from the toe rubbing against the inside of your footwear

Both hammertoe and mallet toe can cause pain with walking and other foot movements.


A common cause of hammertoe and mallet toe is wearing improper footwear — shoes that are too tight in the toe box, or high-heel shoes. Wearing shoes of either type can push your toes forward, crowding one or more of them into a space that's not large enough to allow your toes to lie flat.

The result is a toe that bends upward in the middle and then curls down in a hammer-like or claw-like shape. Your shoes can rub against the raised portion of the toe or toes, causing painful corns or calluses. The bottom of the affected toe can press down, creating the mallet-like appearance of mallet toe.

At first, a hammertoe or mallet toe may maintain its flexibility and lie flat when you're not wearing crowded footwear. But eventually, the tendons of the toe may contract and tighten, causing your toe to become permanently stiff.

Other causes of hammertoe and mallet toe may include:

  • An injury in which you jam your toe
  • Abnormal foot mechanics because of nerve and muscle damage to your toe resulting from diabetes
  • Other diseases that affect nerves and muscles

People with high arches or flatfeet have a greater predisposition to hammertoe and mallet toe than other people do.

Hammertoe and mallet toe > 1 > 2 > 3 > 4

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.

In no event will the be liable for any decision made or action taken in reliance upon the information provided through this web site.
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Dr. Eddy Bettermann M.D.

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