Top of the pageDecision Point

You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Hammer, Claw, or Mallet Toe: Should I Have Surgery?

Get the facts

Your options

  • Have surgery for hammer, claw, or mallet toes.
  • Try nonsurgical treatments for hammer, claw, or mallet
    toes.

Key points to remember

  • Consider surgery if your toe is too painful, if your deformity
    is too great, or if you can’t easily do your daily activities.
  • Your expectations will play a big role in how you feel about the
    results of surgery. Surgery may not help how your foot looks.
  • Your
    toe problems may come back after surgery. This is more likely if you keep
    wearing the kinds of shoes that cause toe problems.
  • Instead of having surgery, you can try wearing shoes with lots
    of room for your toes and using pads and supports in the shoe for protection
    and comfort. Doing toe exercises can help straighten your toes and make your
    toes more flexible.
FAQs

What are hammer, claw, and mallet toes?

Hammer, claw, and mallet toes are toes that do not have the right shape. They may look
odd or may hurt, or both. Tight shoes are the most common cause of these toe
problems.

  • A hammer toe is a toe
    that bends down toward the floor at the middle toe joint. It usually happens in
    the second toe. This causes the middle toe joint to rise up. Hammer toes often
    occur with
    bunions.
  • Claw toe
    often happens in the four smaller toes at the same time. The toes bend up at
    the joints where the toes and the foot meet. They bend down at both the middle
    joints and at the joints nearest the tip of the toes. This causes the toes to
    curl down toward the floor.
  • A mallet toe
    often happens to the second toe, but it may happen in the other toes as well.
    The toe bends down at the joint closest to the tip of the toe.

What are the risks of hammer, claw, or mallet toe?

Hammer, claw, and mallet toes can cause discomfort and pain and may make
it hard to walk. Shoes may rub on your toes, causing pain, blisters,
calluses or corns, or sores. Sores can become infected
and lead to
cellulitis or
osteomyelitis, especially if you have
diabetes or
peripheral arterial disease. If you have one of these
health problems and sores develop, contact your doctor.

What is nonsurgical treatment for hammer, claw, and mallet toes?

You can treat hammer, claw, and mallet toes at home by
doing the following:

  • Wear roomy shoes.
  • Use pads and supports
    for protection and comfort.
  • Do toe exercises. These will make the toe muscles stronger and more
    flexible.
  • Limit activities that cause
    pain.
  • Use over-the-counter medicine to treat pain.

What kinds of surgery are done for hammer, claw, and mallet toes?

If your hammer, claw, or mallet toe gets worse, or if
nonsurgical treatment does not help your pain, you may think about surgery. The
type of surgery you choose depends on how severe your condition is and whether
the toe joint is
fixed (has no movement) or flexible (has some movement). A fixed toe joint often requires surgery to be straightened. A flexible toe joint can sometimes be straightened without surgery.

Surgery choices include:

  • Phalangeal head resection (arthroplasty), in which the surgeon removes part of the toe bone.
  • Joint fusion (arthrodesis), in which the surgeon
    removes part of the joint, letting the toe bones grow together
    (fuse).
  • Cutting supporting tissue or moving
    tendons in the toe joint.

How well surgery works depends on what type of surgery
you have, how experienced your surgeon is, and how badly your toes are
affected.

Surgery may not help how your foot looks. And your toe
problems may also come back after surgery. This is more likely if you keep
wearing the kinds of shoes that cause toe problems.

Your
expectations will play a large role in how you feel about the results of
surgery. If you are only having surgery to improve the way your foot looks, you
may not be happy with how it turns out.

Why might your doctor recommend surgery?

Generally, surgery is used only if your symptoms do not improve with
nonsurgical treatment.

Think about surgery if you have:

  • Bad toe pain that interferes with your daily
    activities, and nonsurgical treatments have not worked.
  • A badly
    deformed foot that interferes with your daily activities.
  • A
    fixed toe joint deformity. This condition typically requires surgery to
    relieve pain and correct the deformity.

Surgery may not be an option if your toe deformity is
caused by a problem with your
nervous system or if you have a condition that affects
your blood vessels, such as diabetes.

Compare your options

Compare

What is usually involved?

What are the benefits?

What are the risks and side effects?

Have surgery for hammer,
claw, or mallet toes

Have surgery for hammer,
claw, or mallet toes

  • You can go home the same day as your surgery.
  • You will not be able to stand or walk for long periods for at least 3 to 6 weeks. You will need to take some time off work, but how long depends on things like the type of surgery you have, whether your usual activity requires certain shoes or not, and what type of work you do.
  • You
    may need crutches for a few days.
  • Relieves pain
  • Allows
    you to walk more comfortably
  • Decreases the risk that you will have skin problems where the hammer, claw, or mallet toe rubs on your shoe
  • Healing may take a long time.
  • You may have swelling
    that doesn’t go away, numbness, or a limited
    range of motion in the affected toe.
  • Surgery may not change how your foot looks.
  • Your toe
    problems may come back after surgery, especially if you keep wearing shoes that
    cause toe problems.
  • All surgery has risks, including infection and problems related
    to anesthesia and bleeding.
Try other treatment

Try other treatment

  • Try wearing shoes with more
    room and using pads and supports to cushion painful toes.
  • Do toe
    exercises to make your toes stronger and more flexible.
  • Take over-the-counter medicine for pain.
  • Provides room for the toe to
    straighten and muscles to get stronger
  • Relieves
    pain
  • Avoids risk of surgery, including swelling and numbness
  • If your toe
    problem is very bad, you may not get relief from your pain.
  • Other
    treatment may not correct the toe deformity.

Personal stories about surgery for hammer, claw, or mallet toes

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

Others in my
family have hammer toes, so I guess I shouldn’t be surprised about getting one,
especially after my doctor told me that wearing high-heeled shoes contributes
to their development. I guess I didn’t realize how much shoes can affect your
feet. My doctor suggested wearing shoes with a lower heel and more room in the
toes, as this could help my foot pain. I’m going to give up high heels and see
if this helps with the pain. I don’t really want to have
surgery.

Diane, age
54

I have a claw toe that is just killing me.
The only time it doesn’t hurt is when I’m barefoot, but I can’t live my life
like that. I gave up high heels and always wear the roomiest shoes possible,
and it still hurts. I’m to the point where the pain is keeping me from doing
things I used to do. I’m going to have surgery to relieve the
pain.

Franny, age
47

I like to run 5 or 6 days a week. My hammer
toe hurts when I run, but I have cut my running shoe so that my toe has room
when I run. I also changed my work shoes to a softer leather that doesn’t hurt
my toe. I know I may need surgery in the future, but I’ve found a way to delay
it for now.

Carlos, age
41

I waitress part-time to make extra money,
and I also really enjoy interacting with the people at my job. The only bad
part is that after a night on the job I have a hammer toe that really hurts.
I’ve gone from high heels to lower heels, but I really can’t do anything else
because my boss doesn’t want me in tennis shoes or something more comfortable.
I guess I could quit, but I don’t want to. My doctor tells me that surgery can
help with my hammer toe, but it could come back if I keep wearing heels. I’m
going to give surgery a try, talk to my boss again, and see what
happens.

Mary, age
50

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to choose surgery for hammer, claw, or mallet toes

Reasons to choose other treatment

I want to do everything I can to fix my toe problem, even if my problem could return after surgery.

I don’t want to have surgery if it might not fix my problem.

More important
Equally important
More important

I want to have surgery even if it won’t improve the way my foot looks.

The only reason I would have surgery is if it would improve the way my foot looks.

More important
Equally important
More important

I’ve already tried wearing roomy shoes, pads, and cushions on my toes. These treatments have not worked.

I haven’t tried wearing roomy shoes, pads, and cushions on my toes. These treatments might work for me.

More important
Equally important
More important

I’m in pain and can’t do daily activities.

My pain isn’t too bad, and I’m still able to do daily activities.

More important
Equally important
More important

I’m not too concerned about the risks involved in foot surgery.

I’m worried about the risks involved in foot surgery.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

Trying other treatment

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, Surgery is a good choice because it will make my foot look better.
2, My toe problems could come back even if I have surgery.
3, Wearing pads in my shoes and changing the kinds of shoes I wear may relieve my pain.

Decide what’s next

1,Do you understand the options available to you?
2,Are you clear about which benefits and side effects matter most to you?
3,Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure

Your Summary

Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you’re leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

Credits

Credits
AuthorHealthwise Staff
Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP – Emergency Medicine
Specialist Medical ReviewerGavin W.G. Chalmers, DPM – Podiatry and Podiatric Surgery
You may want to have a say in this decision, or you may simply want to follow your doctor’s recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Hammer, Claw, or Mallet Toe: Should I Have Surgery?

Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Have surgery for hammer, claw, or mallet toes.
  • Try nonsurgical treatments for hammer, claw, or mallet
    toes.

Key points to remember

  • Consider surgery if your toe is too painful, if your deformity
    is too great, or if you can’t easily do your daily activities.
  • Your expectations will play a big role in how you feel about the
    results of surgery. Surgery may not help how your foot looks.
  • Your
    toe problems may come back after surgery. This is more likely if you keep
    wearing the kinds of shoes that cause toe problems.
  • Instead of having surgery, you can try wearing shoes with lots
    of room for your toes and using pads and supports in the shoe for protection
    and comfort. Doing toe exercises can help straighten your toes and make your
    toes more flexible.
FAQs

What are hammer, claw, and mallet toes?

Hammer, claw, and mallet toes are toes that do not have the right shape. They may look
odd or may hurt, or both. Tight shoes are the most common cause of these toe
problems.

  • A hammer toe is a toe
    that bends down toward the floor at the middle toe joint. It usually happens in
    the second toe. This causes the middle toe joint to rise up. Hammer toes often
    occur with
    bunions.
  • Claw toe
    often happens in the four smaller toes at the same time. The toes bend up at
    the joints where the toes and the foot meet. They bend down at both the middle
    joints and at the joints nearest the tip of the toes. This causes the toes to
    curl down toward the floor.
  • A mallet toe
    often happens to the second toe, but it may happen in the other toes as well.
    The toe bends down at the joint closest to the tip of the toe.

What are the risks of hammer, claw, or mallet toe?

Hammer, claw, and mallet toes can cause discomfort and pain and may make
it hard to walk. Shoes may rub on your toes, causing pain, blisters,
calluses or corns, or sores. Sores can become infected
and lead to
cellulitis or
osteomyelitis, especially if you have
diabetes or
peripheral arterial disease. If you have one of these
health problems and sores develop, contact your doctor.

What is nonsurgical treatment for hammer, claw, and mallet toes?

You can treat hammer, claw, and mallet toes at home by
doing the following:

  • Wear roomy shoes.
  • Use pads and supports
    for protection and comfort.
  • Do toe exercises. These will make the toe muscles stronger and more
    flexible.
  • Limit activities that cause
    pain.
  • Use over-the-counter medicine to treat pain.

What kinds of surgery are done for hammer, claw, and mallet toes?

If your hammer, claw, or mallet toe gets worse, or if
nonsurgical treatment does not help your pain, you may think about surgery. The
type of surgery you choose depends on how severe your condition is and whether
the toe joint is
fixed (has no movement) or flexible (has some movement). A fixed toe joint often requires surgery to be straightened. A flexible toe joint can sometimes be straightened without surgery.

Surgery choices include:

  • Phalangeal head resection (arthroplasty), in which the surgeon removes part of the toe bone.
  • Joint fusion (arthrodesis), in which the surgeon
    removes part of the joint, letting the toe bones grow together
    (fuse).
  • Cutting supporting tissue or moving
    tendons in the toe joint.

How well surgery works depends on what type of surgery
you have, how experienced your surgeon is, and how badly your toes are
affected.

Surgery may not help how your foot looks. And your toe
problems may also come back after surgery. This is more likely if you keep
wearing the kinds of shoes that cause toe problems.

Your
expectations will play a large role in how you feel about the results of
surgery. If you are only having surgery to improve the way your foot looks, you
may not be happy with how it turns out.

Why might your doctor recommend surgery?

Generally, surgery is used only if your symptoms do not improve with
nonsurgical treatment.

Think about surgery if you have:

  • Bad toe pain that interferes with your daily
    activities, and nonsurgical treatments have not worked.
  • A badly
    deformed foot that interferes with your daily activities.
  • A
    fixed toe joint deformity. This condition typically requires surgery to
    relieve pain and correct the deformity.

Surgery may not be an option if your toe deformity is
caused by a problem with your
nervous system or if you have a condition that affects
your blood vessels, such as diabetes.

2. Compare your options

  Have surgery for hammer,
claw, or mallet toes
Try other treatment
What is usually involved?
  • You can go home the same day as your surgery.
  • You will not be able to stand or walk for long periods for at least 3 to 6 weeks. You will need to take some time off work, but how long depends on things like the type of surgery you have, whether your usual activity requires certain shoes or not, and what type of work you do.
  • You
    may need crutches for a few days.
  • Try wearing shoes with more
    room and using pads and supports to cushion painful toes.
  • Do toe
    exercises to make your toes stronger and more flexible.
  • Take over-the-counter medicine for pain.
What are the benefits?
  • Relieves pain
  • Allows
    you to walk more comfortably
  • Decreases the risk that you will have skin problems where the hammer, claw, or mallet toe rubs on your shoe
  • Provides room for the toe to
    straighten and muscles to get stronger
  • Relieves
    pain
  • Avoids risk of surgery, including swelling and numbness
What are the risks and side effects?
  • Healing may take a long time.
  • You may have swelling
    that doesn’t go away, numbness, or a limited
    range of motion in the affected toe.
  • Surgery may not change how your foot looks.
  • Your toe
    problems may come back after surgery, especially if you keep wearing shoes that
    cause toe problems.
  • All surgery has risks, including infection and problems related
    to anesthesia and bleeding.
  • If your toe
    problem is very bad, you may not get relief from your pain.
  • Other
    treatment may not correct the toe deformity.

Personal stories

Personal stories about surgery for hammer, claw, or mallet toes

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

“Others in my family have hammer toes, so I guess I shouldn’t be surprised about getting one, especially after my doctor told me that wearing high-heeled shoes contributes to their development. I guess I didn’t realize how much shoes can affect your feet. My doctor suggested wearing shoes with a lower heel and more room in the toes, as this could help my foot pain. I’m going to give up high heels and see if this helps with the pain. I don’t really want to have surgery.”

— Diane, age
54

“I have a claw toe that is just killing me. The only time it doesn’t hurt is when I’m barefoot, but I can’t live my life like that. I gave up high heels and always wear the roomiest shoes possible, and it still hurts. I’m to the point where the pain is keeping me from doing things I used to do. I’m going to have surgery to relieve the pain.”

— Franny, age
47

“I like to run 5 or 6 days a week. My hammer toe hurts when I run, but I have cut my running shoe so that my toe has room when I run. I also changed my work shoes to a softer leather that doesn’t hurt my toe. I know I may need surgery in the future, but I’ve found a way to delay it for now.”

— Carlos, age
41

“I waitress part-time to make extra money, and I also really enjoy interacting with the people at my job. The only bad part is that after a night on the job I have a hammer toe that really hurts. I’ve gone from high heels to lower heels, but I really can’t do anything else because my boss doesn’t want me in tennis shoes or something more comfortable. I guess I could quit, but I don’t want to. My doctor tells me that surgery can help with my hammer toe, but it could come back if I keep wearing heels. I’m going to give surgery a try, talk to my boss again, and see what happens.”

— Mary, age
50

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to choose surgery for hammer, claw, or mallet toes

Reasons to choose other treatment

I want to do everything I can to fix my toe problem, even if my problem could return after surgery.

I don’t want to have surgery if it might not fix my problem.

       
More important
Equally important
More important

I want to have surgery even if it won’t improve the way my foot looks.

The only reason I would have surgery is if it would improve the way my foot looks.

       
More important
Equally important
More important

I’ve already tried wearing roomy shoes, pads, and cushions on my toes. These treatments have not worked.

I haven’t tried wearing roomy shoes, pads, and cushions on my toes. These treatments might work for me.

       
More important
Equally important
More important

I’m in pain and can’t do daily activities.

My pain isn’t too bad, and I’m still able to do daily activities.

       
More important
Equally important
More important

I’m not too concerned about the risks involved in foot surgery.

I’m worried about the risks involved in foot surgery.

       
More important
Equally important
More important

My other important reasons:

My other important reasons:

  
       
More important
Equally important
More important

4. Where are you leaning now?

Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

Trying other treatment

       
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Surgery is a good choice because it will make my foot look better.

  • True

  • False
  • I’m not sure

You are right. Surgery may not help the way your foot looks.

2.
My toe problems could come back even if I have surgery.

  • True
  • False

  • I’m not sure

You’re right. Your toe problems could come back after surgery. This is more likely if you keep wearing the kinds of shoes that cause toe problems.

3.
Wearing pads in my shoes and changing the kinds of shoes I wear may relieve my pain.

  • True
  • False

  • I’m not sure

That’s right. You can treat toe problems by wearing roomy shoes, pads, and cushions for your toes. Doing toe exercises will also help stretch and strengthen your toes.

Decide what’s next

1.
Do you understand the options available to you?

2.
Are you clear about which benefits and side effects matter most to you?

3.
Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

     
Not sure at all
Somewhat sure
Very sure

2.
Check what you need to do before you make this decision.

  • I’m ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

 
Credits
ByHealthwise Staff
Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP – Emergency Medicine
Specialist Medical ReviewerGavin W.G. Chalmers, DPM – Podiatry and Podiatric Surgery

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