A hammer toe is characterized by hyperextension of the toe at the metatarsophalangeal joint, and flexion contracture of the toe at the proximal interphalangeal joint. The resulting deformity, like a swan's neck, results in retrograde force on the metatarsal head, causing increased plantar pressure, metatarsalgia, callus formation and eventually ulceration. Friction and pressure caused by the shoe on a prominent proximal interphalangeal joint, results in the development of a corn and, eventually, an ulcer. Pressure at the tip of the flexed toe may result in a distal corn and eventually an ulcer (Fig. 8.4a).

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