Dawaa Reference

Clinical reference

Hammer toe

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

Hammertoe - StatPearls - NCBI Bookshelf (NBK559268) - https://www.ncbi.nlm.nih.gov/books/NBK559268/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD71.02 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (3)

  • A slowly worsening bend at the middle joint of the toe, which turns red and sore
  • Long-standing pain that is worse on walking and in shoes, and grows as the deformity progresses [visible deformity]
  • Some feel the pain under the ball of the foot, which goes with the toe joint riding up, slipping or dislocating

Signs — what you find (8)

  • Pressure damage on the skin: blisters, callus, ulcers or soreness over the top of the middle joint, under the ball of the foot, or at the toe tip [blisters]
  • The bend is at the middle joint, with the end joint straight or slightly extended, and the big toe joint may or may not ride up
  • It is usually a lone toe, most often the second
  • Look with the patient standing as well as sitting, because some deformities only show under load
  • A flexible toe deforms on standing and straightens when the ankle is placed passively in neutral; a rigid one stays bent
  • The Lachman test checks stability of the joint at the base of the toe, and the flexibility of each deformity is recorded [visible deformity]
  • Extra tenderness or looseness over the joint surface of the metatarsal head points to a second problem beyond the bent toe
  • Foot mechanics feed the deformity, and hallux valgus often sits alongside it [visible deformity]

Tests (5)

  • Standing AP, oblique and lateral foot films are the mainstay, showing joint contracture and the gun barrel appearance of the proximal phalanx canal
  • Films also compare metatarsal lengths and pick up hallux valgus and metatarsus adductus from overall forefoot alignment
  • Draw a line across the tips of the neighbouring toes; if the affected toe crosses it, the toe is too long
  • MRI is for suspected plantar plate rupture or other soft tissue and bone problems, and shows dead bone in the metatarsal head, usually the second, plus cartilage defects
  • With diabetes, peripheral neuropathy or vascular disease, non-invasive arterial studies gauge blood supply and healing

If not this — what else fits (9)

  • Claw toe: both toe joints bent with the joint at the base pulled up
  • Claw toe is generally worse, hits several toes on both feet, goes with neuromuscular disease, and sits on a high-arched foot
  • Mallet toe, where only the end joint is bent
  • Turf toe
  • Sesamoiditis or gout
  • Osteochondrotic lesion of the first metatarsal head
  • Osteochondritis dissecans
  • Metatarsalgia
  • Metatarsal stress fracture

SourceStatPearls "Hammertoe" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

A bent, fixed deformity of a toe joint; managed with footwear modification, toe padding, and analgesia, with surgical referral if severe or if the deformity ulcerates. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

A bent, fixed deformity of a toe joint; managed with footwear modification, toe padding, and analgesia, with surgical referral if severe or if the deformity ulcerates.

Cautions
  • Skin ulceration or infection over the deformity, particularly in patients with diabetes or peripheral vascular disease.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.