Hammertoe vs. Mallet Toe vs. Claw Toe: What’s the Difference?

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

The terms hammertoe, mallet toe, and claw toe are frequently used interchangeably — but they describe distinct deformities affecting different toe joints. Understanding the difference helps explain why treatment approaches vary, and why a diagnosis should be specific rather than generic.

Anatomy First: The Three Toe Joints

Each lesser toe has three joints:

• MTP (metatarsophalangeal) joint — where the toe meets the foot; the “knuckle” at the base of the toe
• PIP (proximal interphalangeal) joint — the middle toe joint
• DIP (distal interphalangeal) joint — the outermost toe joint, closest to the toenail

Hammertoe

A hammertoe is a flexion contracture (downward bending) of the PIP joint — the middle joint — while the MTP joint is in a neutral or extended position. The toe takes the shape of an inverted “V” when viewed from the side. In a flexible hammertoe (early stage), the toe can still be straightened manually. In a rigid hammertoe, the contracture is fixed and cannot be manually corrected.

Most common location: Second toe, though any lesser toe can be affected.

Cause: Intrinsic-extrinsic muscle imbalance — the long extensor tendons overpower the weakened intrinsic muscles (lumbricals and interossei), causing the proximal phalanx to extend at the MTP and the middle phalanx to flex at the PIP.

Mallet Toe

A mallet toe is a flexion contracture of the DIP joint — the outermost toe joint. The MTP and PIP joints remain relatively normal; only the toe tip droops downward. This produces a characteristic corn at the tip of the toe where it presses against the ground or shoe.

Most common location: Second or third toe.

Cause: Flexor digitorum longus tendon overactivity or shortened length, often from wearing shoes that are too short; less commonly from traumatic tendon injury.

Claw Toe

A claw toe involves hyperextension at the MTP joint combined with flexion contracture at both the PIP and DIP joints — producing a claw-like appearance. The MTP joint is pushed up (extended) while both interphalangeal joints curl downward.

Pattern: Often affects multiple toes simultaneously.

Causes: More complex etiology — often associated with neurological conditions (Charcot-Marie-Tooth disease, peripheral neuropathy), rheumatoid arthritis, or intrinsic muscle loss from diabetes or alcohol neuropathy.

Key Differences at a Glance

• Hammertoe: PIP joint flexion only; MTP neutral or slightly extended
• Mallet toe: DIP joint flexion only; MTP and PIP relatively normal
• Claw toe: MTP extension + PIP and DIP flexion; often bilateral and multiple toes

Treatment Comparison

All three deformities are treated with the same general approach:

• Conservative (flexible deformities): Wider toe box footwear, toe spacers, padding over corn/callus areas, orthotics with metatarsal pad, splinting
• Surgical (rigid or progressive deformities): PIP arthroplasty or arthrodesis (hammertoe), DIP tenotomy or arthroplasty (mallet toe), or combined MTP release with PIP/DIP correction (claw toe)

Hammertoe, Mallet Toe & Claw Toe Treatment in Michigan

Dealing with bent or curled toes causing pain and difficulty with shoes? Our podiatrists offer comprehensive toe deformity treatment from padding and splinting to minimally invasive surgery.

Learn About Our Hammertoe Treatment Options → | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Coughlin MJ. Lesser-toe abnormalities. The Journal of Bone and Joint Surgery, 2002;84(8):1446-1469.
2. Shirzad K, et al. Lesser toe deformities. Journal of the American Academy of Orthopaedic Surgeons, 2011;19(8):505-514.
3. Schrier JC, et al. Definitions of hammer toe and claw toe: an evaluation of the literature. Journal of the American Podiatric Medical Association, 2009;99(3):194-197.