Hammer toe

Patient Information

https://www.bofas.org.uk/Patient-Information/Lesser-Toes

GP Information

Background Information

• Abnormal flexion of the PIPJ of any lesser toe with DIP extension due to a muscular imbalance.
• May be rigid or flexible and is most commonly found in the second toe of elderly women.
• Patients may complain of pain on wearing shoes and deformity.
• Examination may reveal a positive push up test.

Investigation Guidelines

• Investigations are not required for diagnosis, management, or referral.

Management Recommendations

Conservative measures include

• Patient education.
• Shoe wear advice – avoid totally flat, high, or tight shoes. Trainers are appropriate.
• Silicone / foam toe sleeve.

Referral Indications;

• Diagnostic uncertainty.
• Chronic pain / disability not responding to conservative management.
• Unable to wear normal shoes.