Claw and Hammer Toes

Conditions that deform the shape of the four smaller toes, leaving them in a curved position

Aetiology

  • Occur due to acquired imbalance between the flexor and extensor tendons
  • Claw toes have hyperextension at the MTPJ with flexion at the PIPJ and DIPJ
  • Hammer toes have PIPJ flexion, DIPJ extension and neutral MTPJ

Clinical presentation

  • Claw and hammer toes can be painful and can rub on footwear causing corns and skin breakdown
notion image

Management

  • Toe 'sleeves' and corn plasters can prevent skin problems
  • Surgical solutions include tenotomy (division of an overactive tendon), tendon transfer, arthrodesis (PIPJ) or toe amputation