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Mallet Toe

Image of Mark McFarland, DO
Mark W. McFarland, DO
At OSC, we see patients with orthopaedic issues on a daily basis, including those with foot problems.  A common foot deformity condition we treat is called Mallet Toe. Here, I will describe the condition and explain how it is treated.
Whenever a second, third or fourth toe bends abnormally at the first joint, it is called Mallet Toe, because it resembles a mallet. Wearing footwear, walking, or running is typically painful, and movement of the toe may be difficult.  A callus, blister or corn may form either at the abnormally bent toe joint or on the tip of the toe where it points downward, or both, because of rubbing on footwear or walking surfaces. Ulcer(s) can form at the site(s) of the corn or callus and become infected. The toe can become permanently bent, requiring surgery to straighten.
Mallet toe can be caused by any condition or injury affecting the joints, such as arthritis.  Diabetes also raises your risk.   If you have ever stubbed, jammed or broken a toe, your risk for Mallet Toe increases.  Mallet toe happens more often as you get older and more often to women than to men.  If your mom or dad had mallet toe, you may also develop the condition.
Diagnosing Mallet toe is done by examining the toe, taking x-rays, and talking to the patient about their symptoms. Treatment involves using shoe inserts and orthotics to better position the foot and shoe pads and padded socks can cushion the bent toe.  It is important to buy shoes with wide toe boxes to allow more room and low heels are recommended. Toe Exercises should be done and a referral to Physical Therapy may be recommended. Think of wiggling and stretching your toes in the sand at the beach or picking up a seashell with only your toes and you get the idea of what these exercises do for the feet and toes. If caught early enough, the progression of Mallet Toe can be arrested.
If the tendon in the toe has permanently constricted movement, surgery may be needed.  Your surgeon will release the tendon bending the toe and may shorten your toe and/or remove a piece of bone.  After your toe is straightened in surgery, pins or rods may hold the toe in place while it heals and will be removed about a month after surgery.  A toe joint fusion may be necessary in extreme cases.
The length of your recovery will be determined by the severity of your toe deformity and the surgery required to fix the issue.  A special shoe for your operated foot will be given to you, so that you can safely walk while recovering.  Crutches or a walker may be prescribed.  Keeping the foot elevated during the first 10 to 14 days post-surgery is vital.  If your toe has surgical pins, do not submerge it in water until the pins are removed, as it poses an infection risk. If your right foot was affected, do not drive until released to do so by your surgeon. Six weeks is usually sufficient time for recovery and healing, although you may see post-operative swelling for up to a year.
It is easier to prevent Mallet Toe than to correct it.  Get rid of the high heels with pointy toes.  Instead, wear footwear with low heels and plenty of room in the toes. Remember those toe exercises I mentioned earlier? Get busy and do toe exercises daily to ward off future problems. Since Mallet Toes can be inherited, and IF your mom or dad were affected, you should monitor the health of your toes.  If you notice one or more starting to unnaturally bend or cause pain, get to a doctor for diagnosis and treatment.  Taking action quickly can ward off years of foot problems and even surgery.

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