Mallet Toe

Mallet toe looks curled because of a bend in the upper joint of the toe. Like hammertoes, mallet toes are usually caused by ill-fitting shoes, which tend to force the foot against the front part of the shoe, forcing an unnatural curve.

Ill-fitting shoes may also cause painful corns to develop on the top of the toes. Mallet toes may also be caused by nerve and muscle injuries (neuropathy) triggered by health conditions such as osteoarthritis, rheumatoid arthritis, stroke and diabetes.

Initially, mallet toes maintain their flexibility. Over time, however, the tendons may begin to tighten, causing the toes to become stiff permanently.

Any toe can become a mallet toe, but the second toe is typically more prone. Mallet toe surgery is rarely necessary – in most cases, a simple change in footwear and special orthotics are enough to relieve the condition. Surgery is often a last resort for severe cases.

 

What are the symptoms of mallet toe?

Mallet toes looks similar to hammertoe, except that the deformity is at the top joint (not the middle joint). Patients usually find it hard to move mallet toes. More often than not, corns and calluses also develop on the affected toes, causing pain.

 

What causes mallet toes?

Like hammer toes, mallet toes are mainly caused by improper footwear. Shoes with very small or tight toe boxes and/or high heels shoes are culprits. Such types of shoes tend to push the toes forward so that they crowd together and cannot lie flat. The toes then bend upward and then curl down to become claw-like. These shoes also rub against the mallet toes, contributing to the development of calluses and corns.

Injuries that involve jamming or breaking of the toes can also cause mallet toes. Muscle and nerve damage, diabetes, and other conditions such as stroke also contribute.

 

How to diagnose?

Once your mallet toes begin to cause persistent pain and starts to affect your ability to walk or stand properly, you need to see a doctor. The doctor can typically immediately diagnose a mallet toe by administering a simple physical exam.

 

Mallet toe correction methods

Treatment of mallet toes can either be conservative or surgical.

If the mallet toes are still flexible, a simple switch to shoes with more toe room may already alleviate the pain. The doctor may also recommend shoe inserts (also called orthotics) or stress-relieving pads which can help reposition and take the pressure off the toes.

Inflexible mallet toes are harder to treat – in most cases, mallet toe surgery becomes necessary. The surgical procedure will depend on the degree of inflexibility of the mallet toes. If there is some flexibility left, the doctor may make an incision to release the tendon and straighten the toes. If the mallet toes have already become very stiff, the tendons may have to be realigned and some bones may be removed to straighten the affected toes. The bones are usually fixed with pins (only temporarily) while the mallet toes heal. Surgery is usually fast – patients can typically go home right after the toe surgery.