Mallet Toe

Mallet toe is a deformity in which the joint at the very end of the toe buckles and bends in an unnatural, oftentimes painful position. The joint in unable to straighten, leading to a fixed downward bend. It is different from hammertoes, which is when the second interphalangeal joint of the toe bends downward.

Symptoms

Usually a person can tell if he or she has mallet toe based on the appearance of the little toes, which will be bent downward at the very last (distal interphalangeal) joint of the toe. The skin on the end of the affected toes usually develops calluses or corns due to their abnormal position, which can lead to irritation and rubbing. Sometimes redness and swelling is present.

The second toe of the foot is the most likely toe to experience mallet toe.

Causes

Most cases of mallet toe are caused by wearing shoes that don’t fit properly or that squeeze the toes together. Toes that are repeatedly bent into unnatural positions can tighten and lose their ability to stretch out.

In some cases, mallet toe is due to a muscle/tendon imbalance or a previous injury to the toe area. Arthritis can also cause mallet toe to develop.

Treatment

Most cases of mallet toe can be treated with non-surgical, conservative methods. Treatment usually includes relieving pressure and reducing friction by choosing comfortable, properly fitted shoes with wide toe boxes, using a pumice stone to reduce corns and calluses, engaging in foot and toe stretches to help keep the affected muscles flexible, and possibly wearing gel cushions, straps and/or orthotic devices while the toes improve. Corticosteroid injections and oral nonsteroidal anti-inflammatory drugs (NSAIDs) are sometimes recommended to help control pain and swelling.

If left untreated, a mild case of mallet toe could become a permanent toe deformity leading to repeated corns, calluses and/or open sores. Surgery is an available option to help re-position the toes, but it is rarely recommended because it can lead to nerve injury, infection and increased stiffness of the toes. Recurrence of mallet toe is also a possibility, especially if the patient returns to ill-fitting or uncomfortable shoes. A podiatrist or orthopaedic surgeon can help you decide if mallet toe surgery is the best option for you.