What causes hammertoe and mallet toe?
These deformities have several well-established causes which include:
- Poorly fitting footwear: any shoes or boots which don’t allow the toes to lie flat have the potential to cause either deformity. Overly tight toe boxes are also major contributors. Note that high-heeled shoes are notorious for causing these conditions and several others.
- Injury: trauma such as a severely stubbed toe can set a patient up for hammer or mallet toe. Poorly set fractures can also play a role.
- Abnormal toe musculature: this can cause poor biomechanics which can lead to a host of foot conditions. This includes the deformities mentioned above.
Common risk factors for hammertoes
Some patients are much more likely to develop foot deformities than others. Common risk factors include:
- Age: hammertoes and mallet toes occur much more frequently in the 5th-7th decades.
- Gender: females are more prone to these conditions than males. The exact reasons for this are unknown.
- Length of toes: individuals with a 2nd toe that’s longer than the big toe are at an elevated risk.
- Systemic diseases: those with certain types of arthritis are more prone to developing these deformities. This includes osteoarthritis and rheumatoid arthritis. Diabetes can also be a contributing factor..
- Heredity: if you have a close relative with hammertoes or mallet toes you may be affected as well.
Complications of hammertoes and associated deformities
In its early stages a hammer or mallet toe will usually have some flexibility. In later stages, especially without early treatment, the tendons which cross the toe joints become permanently contracted. This in turn permanently fixes the toe into an abnormal position. At this point surgery is often the only viable option for re-straightening the toe.
Once the deformity becomes permanent the raised portion of the toe tend to rub against the patient’s shoe. This leads to repetitive friction which can cause blisters, corns, and calluses which range from mildly uncomfortable to outright painful.