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When Hammertoe (Hallux malleus, Digitus malleus) refers to a malposition of a toe, in which usually the middle member upwards and the end member are bent downwards. Mostly, this disease is not innate, but is favored by foot deformities. With a suitable footwear or a hammer toe operation, the malposition can be treated. Here you can read all important information about causes, symptoms and treatment options with a hammer toe.

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. Q66M20ArtikelübersichtHammerzeh
  • description
  • symptoms
  • Causes and risk factors
  • Examinations and diagnosis
  • treatment
  • Disease course and prognosis

Hammerzeh: description

In a hammertoe (Hallux malleus, Digitus malleus), the toe center joint is bent so high that the end member points to the ground like a hammer. There is also a rarer form of this deformity, in which only the final limb is affected: the end joint hammer toe (Malletzehe). In her, the end joint is so strongly curved that the toe tip touches the ground.

Most people affected by hammertoes also have foot deformities such as splayfoot, hollow foot or ball toe (hallux valgus). Rarely is a hammer toe innate.

Even minor deformities can cause pain. If the hammer toe is pronounced, those affected will often find no more suitable shoes. Especially with this disease, a good footwear is indispensable. With a slight misalignment, well-fitting shoes can often improve the symptoms. Alternatively, a hammer toe operation is possible, in which there are various surgical techniques.

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Hammerzeh: symptoms

A hammer toe does not necessarily lead to discomfort. Mostly people only go to the doctor if they are in pain. Others suffer from their foot shape being visually altered by the hammer toe. If the disease progresses, those affected no longer find any shoes that suit them well. If the shoes are pressed, horny calluses, such as corns on the toes or underneath the ball of the foot, can also increase in a hammer toe. Partially, these splinters cause severe pain.

For all the symptoms described, it should be noted that they need not be related to the degree of malposition. Even a slight hammer toe can cause severe discomfort, while other people feel no symptoms, even with pronounced hammer toes.

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Hammerzeh: causes and risk factors

Most hammertoes occur in the course of life. There are certain risk factors that favor this malposition:

Inappropriate footwear:

Especially too small or too narrow shoes can cause the toes to be compressed. In the long run, the foot muscles are weakened and can control the position of the toes less and less. At first, the toe can be bent well up and down by hand. But if the toes are caught in unfavorable shoes for a long time, the deformation remains firm.

Accompanying foot deformity:

A splayfoot or hollow foot changes the arch of the foot. If the foot is over- or misaligned in one of these misalignments due to overweight or unsuitable shoes, the forefoot loses its tension. The longitudinal vault sinks, and the toes diverge. This changes the pulling direction of the muscles and tendons. The toes are bent like a hammer.

Even with a ball toe (hallux valgus) hammer toe can arise. Sometimes the big toe deviates so much from the outside that it slides under the other toes or displaces them.

Neurological disorders:

Spastic paralysis sometimes causes muscle cramps (contractures) on the feet, which can lead to a hammer toe. Also with other neurological illnesses like the Friedreich Ataxie arise more frequently hammer toes. This is because sufferers often also suffer from a hollow foot, which represents a risk for a hammer toe.

After trauma:

A trauma (such as an accident) can result in a so-called compartment syndrome - a massive, circumscribed pressure increase in the tissue, which can affect the blood circulation and disrupt the function of muscles and nerves. As a result, a hammer toe can arise.


Rheumatoid arthritis is a chronic arthritis. It can also occur in the toe joints and favor a hammer toe.

A hammer toe is congenital in rare cases. Then it occurs even in toddlers who can not even walk and do not wear constricting shoes. These children are usually affected by both feet, preferably the second toe. Initially, the toe tip is slightly bent down. In the first years of life it is still possible to flexibly move the affected toe. But if you do not treat the hammer toe, the toe joints can stiffen. It forms a typical hammer toe.

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Hammerzeh: examinations and diagnosis

A hammer toe usually recognizes a doctor when he looks at his foot. This diagnosis is supported when the patient reports the typical symptoms.

The doctor checks if the toe can still move. This allows him to distinguish whether it is a stiff (contract) or flexible (flexible) form of hammer toe. In a flexible malposition, the doctor can compensate for the curvature when he pushes from the sole of the foot against the toe joint (push-up test). With a stiff misalignment this does not work. The distinction between a stiff and a movable hammer toe is important for a correct treatment.

Sometimes X-rays of the foot are made. Above all, they serve to plan a hammer toe operation.