Hammer Toe M20.40 735.4

hammer toe 
ICD-9 Classification / Treatment
Etiology / Natural History Associated Injuries / Differential Diagnosis
Anatomy Complications
Clinical Evaluation Follow-up Care
Xray / Diagnositc Tests Review References

synonyms:hammer toe

Hammer Toe ICD-10

Hammer Toe ICD-9

  •  735.4 Acquired deformity of toe; other acquired hammer toe

Hammer Toe Etiology / Epidemiology / Natural History

  • PIP joint flexion deformity
  • Most common lesser toe deformity
  • Caused by overpull of the EDL and intrinsic imbalance
  • Generally involves the 2nd toe

Hammer Toe Anatomy


Hammer Toe Clinical Evaluation

  • Generally complain of painfull callus over the flexed PIP joint and difficulty with shoe wear
  • Push-up Test: passive push-up of the metatarsal head corrects the deformity in flexible cases by removing the overactivve extrinsic muscles

Hammer Toe Xray / Diagnositc Tests

  •  Consider AP, lateral and oblique foot films

Hammer Toe Classification / Treatment

  • Flexible  deformity: accomidative footwear, protective padding.  Consider transfer of FDL dorsally over midshaft of prox phalanx.
  • Fixed deformity: Resection arthroplasty of the head and neck of the proximal phalanx vs PIP arthrodesis.
  • Fixed deformity with MTP joint dislocation:  PIP resection arthroplasty, extensor tendon lengthening, and Weil osteotomy.

Hammer Toe Associated Injuries / Differential Diagnosis

Hammer Toe Complications

Hammer Toe Follow-up Care


Hammer Toe Review References

  • Myerson MS, Fott and Ankle Disorders WB Saunders, 2000
  • Coughlin MJ, Dorris J, Polk E. Operative repair of the fixed hammertoe deformity. Foot Ankle Int. 2000 Feb;21(2):94-104