Toe Deformities

Toe Deformities

Hammer toe, claw toe, mallet toe, crossover toe — small deformities of the lesser toes that cause big shoe-fit problems. The aim of correction is a toe that fits in a normal shoe without rubbing.

Royal College British Orthopaedic AO Trauma Churchill Limb Recon Specialist Reg.
27
Years of practice
94
Publications
3
Sub-specialty areas
3
Central London clinics

Foot & Ankle · Professor Nima Heidari

Toe Deformities

Hammer toe, claw toe, mallet toe, crossover toe — small deformities of the lesser toes that cause big shoe-fit problems. The aim of correction is a toe that fits in a normal shoe without rubbing.

Mallet toe, claw toe and hammer toe are all deformities relating to the smaller toes.

In a hammer toe the middle joint of the toe buckles; in a claw toe the toe curls down at both joints; and in a mallet toe it bends at the joint nearest the nail. They arise from an imbalance between the tendons that bend and straighten the toe, and often appear alongside a bunion or in a foot with a high arch.

The trouble they cause is mechanical: the prominent joint rubs in shoes, forming painful corns over the top of the toe or at the tip, and the toe can become stiff and fixed if left. Early on, while the toe is still flexible, roomier footwear, padding and orthotics relieve the pressure and keep symptoms in check.

When a toe has become fixed or the rubbing is persistent, a small operation straightens it — rebalancing the tendons and, where needed, addressing the joint — so it sits comfortably in a shoe again. The right procedure depends on which toes are involved and how stiff they have become.

Toes are small. The operations are small. The relief from a toe that no longer rubs in every shoe is not.

Professor Heidari

Clinical approach

How Professor Heidari typically approaches it

Test for flexibility

A flexible deformity (one you can passively straighten) may be correctable by soft-tissue means alone. A fixed deformity needs a small bony procedure.

Address the cause, not just the toe

Toe deformities rarely arrive in isolation — bunions, transverse arch collapse and plantar plate failure often sit underneath them. The plan addresses the whole pattern.

Day-case where possible

Many lesser-toe corrections are day-case operations under regional anaesthetic, with walking in a flat post-op shoe from day one.

Treatments considered

The options

Toe deformities

Surgery is by no means necessary for all patients with small toe deformities. Straightening your toes non-surgically using a combination of special medical shoes and pressure-relieving insoles can be enough to solve the problem.

Common questions

What patients ask first

Can a hammer toe be fixed without surgery?
Flexible hammer toes can sometimes be improved with toe-spacers, taping, footwear changes and physiotherapy. Once the deformity is fixed, surgical correction is the only reliable option.
Will my toe be straight afterwards?
The aim is a toe that fits comfortably in a normal shoe and no longer rubs. “Ruler-straight” is not a realistic target after a fixed deformity has been present for years — comfortable and functional is.
How long until I'm in normal shoes?
Around 6 weeks for many lesser-toe corrections, sometimes earlier. The exact timeline depends on which procedure was done.
Can multiple toes be done at the same time?
Yes — multiple lesser-toe corrections at the same operation are routine, often combined with bunion correction. Recovery is similar.
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Signed off on 30 July 2026