Hammer Toe & Claw Toe

Hammer toe is a flexion deformity at the PIP joint of a lesser toe, with the MTP joint neutral or hyperextended. Claw toe involves flexion at both PIP and DIP joints with MTP hyperextension — a result of intrinsic muscle imbalance often associated with neurologic conditions or severe cavus foot. Mallet toe is isolated DIP flexion. The deformities can be flexible (passively correctable) or rigid (fixed), which determines the surgical approach.

The second toe is most commonly affected. Long-standing deformities cause painful dorsal corn formation at the PIP joint and plantar callus under the metatarsal head.

Clinical examination assessing flexibility (passive MTP/PIP/DIP correction) and neurovascular status. Weight-bearing X-rays define bony alignment. Associated first ray pathology (bunion, hallux rigidus) is assessed simultaneously.

1. Metatarsal pad

   Alleviates associated metatarsalgia.

Surgery is indicated for painful rigid deformities or flexible deformities that have failed non-surgical accommodation.

External patient-education references and related OSI pages for additional background:

• Britannica — Ankle (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language