What is a hammer toe/ claw toe/ mallet toe?
There are different types of small toe deformities: claw toes, hammer toes, and mallet toes.
Claw toe: Involves an upward bending of the toe joint at the ball of the foot. The middle joint, and sometimes the end joint as well, the toe bends downward in a claw-like fashion, often digging into the sole of the foot. This can occur in any toes except the big toe.
Hammertoe: Toe is bent at the middle joint causing a curling of the toe. Most common in the second toe but can occur in any toes. Hammer toes are often present along with a bunion deformity.
Mallet toe: Similar to hammertoe except the joint involved is the last joint (DIPJ) instead of knuckle joint (MPJ), giving the toe a mallet-like appearance at the end of the toe.
The small toes are important in walking, especially when pushing off with the foot towards the next step. They share the pressure with the big toe and the ball of the foot. Toes become deformed when the pressures on the toe are stronger than their joints can resist. This may be because the joints are weak or the pressures strong, or both. The joints may be weak because they have been damaged by injury or arthritis. The muscles that control them may become unbalanced, so that one set pulls harder than others and causes the toe to bend. In some people the tissues in the lower part of the joint at the base of the toe (metatarso-phalangeal joint or MTPJ) become weak, allowing the base of the toe to drift upwards and unbalancing it.
The main pressures which cause toes to become deformed, come from shoes which press on the tip of the toe, either because the shoe is tight or because it has a high heel, which tends to force the toes into the tip of the shoe. The main problem with deformed toes is that they tend to rub on shoes, either on top of the PIPJ or at the tip or both. This rubbing may simply be uncomfortable, or the skin may be rubbed raw, and this may result in ulcers.
If the MTP joint is bent upwards, the toe may press down and cause pain in the ball of the foot (“Metatarsalgia”) Bent toes may rub on one another or on the big toe, especially in case of concurrent bunion deformity.