Hammer toes / claw toes
Understanding this condition
Hammer toes and claw toes are deformities of the lesser toes (the 2nd, 3rd, 4th, or 5th toe) that curl up and no longer lie flat. A claw toe is the classic "balled-up" deformity on the top of the toe; a hammer toe is a variant.
These deformities result from an imbalance between the tendons that flex and those that extend the toe. They often accompany hallux valgus, or appear in isolation (narrow footwear, cavus foot, post-sprain sequelae).
Symptoms
Corns and calluses on the tip of the toe or on top (rubbing with the shoe), often painful. Difficulty fitting shoes. Associated metatarsalgia (pain under the forefoot).
At an advanced stage, the toe becomes rigid and the deformity is fixed (can no longer be manually straightened).
How can it progress?
The deformity progressively stiffens and becomes irreducible. Pain worsens and footwear becomes impossible. Corns can become infected, especially in diabetic patients.
The later management is undertaken, the more complex the surgery.
Treatment options
At the flexible stage (toe still reducible): orthotics, separators, wide footwear.
At the rigid stage or when pain is disabling: corrective surgery. Several combined techniques are possible (tendon releases, Weil osteotomy, interphalangeal arthrodesis). A consultation assesses reducibility and guides the technique.