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Mallet Toe

What is a Mallet Toe?

A mallet toe is often confused with a hammertoe. While a hammertoe has an abnormal bend in the middle joint of a toe, a mallet toe affects the joint nearest the toenail.

Causes

A mallet toe is a foot deformity that occurs due to an imbalance in the muscles, tendons or ligaments that normally hold the toe straight. The type of shoes you wear, foot structure, trauma and certain disease processes can contribute to the development of this deformity.

Signs & Symptoms

Common symptoms of a mallet toe includes:

  • Pain or irritation of the affected toe when wearing shoes.

  • Corns and calluses (a buildup of skin) on the toe, between two toes or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending on their location.

  • Inflammation, redness or a burning sensation

  • Contracture of the toe

  • In more severe cases of a mallet toe, an open sore may form.

Nonsurgical Treatment

There is a variety of treatment options for mallet toes. The treatment your foot and ankle surgeon selects will depend on the severity of your mallet toe and other factors.

A number of nonsurgical measures can be undertaken:

  • Padding corns and calluses. Your foot and ankle surgeon can provide or prescribe pads designed to shield corns from irritation. If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult your surgeon about this option.

  • Changes in shoewear. Avoid shoes with pointed toes, shoes that are too short, or shoes with high heels—conditions that can force your toe against the front of the shoe. Instead, choose comfortable shoes with a deep, roomy toebox and heels no higher than two inches.

  • Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance. Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation caused by a mallet toe. 

  • Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation. Splinting/strapping. Splints or small straps may be applied by the surgeon to realign the bent toe.

When is Surgery Needed?

In some cases, usually when the mallet toe has become more rigid and painful or when an open sore has developed, surgery is needed.

Often, patients with mallet toes have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination of procedures for your particular case, the foot and ankle surgeon will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.