Mallet Toe Treated by Mercy's Top Foot Surgeons in Baltimore

Mallet toe is a deformity involving the lesser toes. In a mallet toe, the joint at the very tip of the digit flexes downwards towards the floor. 

The second toe is commonly affected because this toe is often the longest, but any of the lesser toes may be involved. The most frequent cause of mallet toe is tight fitting shoes that compress the toes into a narrow toe box. When the toes are repetitively held in this position, the tendons and ligaments eventually become contracted which makes the deformity permanent. 

The causes of mallet toe include:

• Tight fitting shoes
• Injury to the toe
• Arthritis
• Imbalance of the muscles controlling the toes

Patients with mallet toes often complain of pain at the tip of the toe where the toe rubs against the floor. Symptoms of mallet toe include:

• Calluses and pain at the tip of the toe
• Redness and irritation on the top of the toe
• Difficulty with shoe wear
• May develop into ulcers in patients with diabetes

The orthopedic foot and ankle specialist will examine the mallet toe to determine if the deformity is flexible or rigid. This will help determine the type of procedure to perform if surgery is required. X-rays can help identify signs of trauma or arthritis.

Non-surgical Treatment Options for Mallet Toe

• Shoes with a high, wide toe box
• Silicone toe sleeves that cover the tip of the toe
• Toe crest pad that keeps the tip of the toe from contacting the ground
• Routine trimming and paring of calluses

Surgical Treatment for Mallet Toe

• Flexible mallet toe deformities can be treated with soft-tissue procedures that release the over-tight flexor digitorum longus tendon. A temporary metal pin may be placed across the joint to hold the correct alignment. This wire is usually removed in the office.
• Rigid mallet toe deformities require a bony procedure called a fusion. The joint near the tip of the toe is opened and the cartilage is removed. The bone on either side of the joint is roughened up so that it bleeds and then the two sides of the joint are compressed together by a screw or pin. The two bones will eventually heal together into a single straight bone that will never deform again.