Claw toe can be something that a child is born with (congenital) or can develop as a consequence of disorders (acquired). Claw toes may result from a problem with the (peripheral) nerves in the leg or from a spinal cord problem. Many cases have an unknown cause. Claw toes in and of themselves are not usually dangerous, but sometimes they are the first symptoms of a more serious disease of the nervous system. Claw toe is a dorsiflexed proximal interphalangeal joint, flexed metatarsophalangeal joint, and flexed distal interphalangeal joint.

Hammer toe is a deformity of the toe in which the end of the toe is bent downward. Hammer toe usually affects the second toe, although it can also affect the other toes. The toe assumes a claw-like position. The condition may occur as a result of pressure from a bunion. A corn on the top of a toe and a callus on the sole of the foot develop, which makes walking painful. A high foot arch may also develop. Hammer toe is a contracture of metatarsophalangeal joint, dorsiflexed proximal interphalangeal joint, and plantarflexed metatarsophalangeal joint.

Mallet toe occurs when the joint at the end of the toe cannot straighten up. Excessive rubbing of the mallet toe against the top of the shoe can lead to pain and the development of a corn. The tip of the toe is often turned down against the shoe causing pressure and discomfort. Development of mallet toes is often caused by bone and muscle imbalances. People who are constantly on their feet or participate in athletic activities are more likely to develop mallet toes. Arthritis can also lead to many forefoot deformities including mallet toes. Mallet toes can cause extreme discomfort. Mallet toes can be aggravated if restrictive or improperly fitting footwear is worn for a long period of time. Mallet toe is a variation of hammer toe in which distal interphalangeal joint is plantarflexed.

Symptoms:
• Changes in gait and balance
• Redness and swelling on and around the affected toe
• Corns or calluses where the toe bends and rubs
• An infection may develop
• Ulcers sometimes develop in patients with diabetes, who have decreased sensitivity in the foot
• It may be difficult to find shoes that accommodate the deformity

Possible Modality:
• Full-length functional custom made orthotics to unload the metatarsal heads and provide accurate toe crest.
• Functional custom made orthotics with metatarsal pad placed proximal to metatarsal heads secondary to deformity.
• Hammer-toe splints apply corrective forces to toe