Professore Valerio Sansone Chirurgo Ortopedico

Il Piede / Deformità delle dita

What are toe deformities?
There are 3 bones, called phalanges, in each of the lesser toes (the big toe only has two) which should lie flat in a straight line.  There are tendons running above and below these bones which enable you to bend and lift your toes.  If the muscles of these tendons are out of balance they will tighten excessively, contracting the tendons, which pull one or all of the bones out of position and thus forcing the joints to bend.  The joints then rub against your shoes forming painful calluses, and making walking uncomfortable.  Eventually the bones become set in the abnormal position, and surgery is required to correct them. The main deformities are as follows:

  • Hammer toe – the first bone or phalanx is pulled upwards, the second tilts down, and the third is almost flat
  • Claw toe – the first phalanx points upwards, but the second and third point downwards, making the toe curl like a claw
  • Mallet toe – only the tip of the toe (third phalanx) is pulled downwards whilst the first two bones are in line.

What causes them?
Toe deformities can be caused by shoes that are too tight, particularly if they have high heels or are pointed, and as a result, they are much more common in female patients.  Hammer toes in the second toe are often caused by bunions (see Hallux Valgus) as the big toe pushes the smaller toe out of position.  However they can also be caused by other foot abnormalities such as flat feet, high foot arches (pes cavus), or be the result of injury or an underlying nerve disease.

How do they feel?

The calluses that form on the deformed joints and/or the tip of the toe will be painful, and the toe may become inflamed.

Your doctor will be able to diagnose a toe deformity simply by looking at your foot, although he may ask for X-rays to show the exact position of the bones, and to see if there are other problems in the rest of your foot.