Which deformity is caused by tightening of muscles underneath the toe and genetic or acquired?

• A. Claw toe
• B. Tailor's bunion/bunionette
• C. Hammertoe
• D. Foot drop/Drop foot

Answer: (C)

Tight toe flexor muscles under the toe pull the middle joint of the toe into a bend, creating a hammer-like deformity at the proximal interphalangeal joint. This imbalance between the underside (flexor) muscles and the toe’s supporting structures can be genetic or acquired, such as from ill-fitting footwear or changes that shorten the flexor tendons. As a result, the toe stays bent at the PIP with the rest of the toe not equally aligned, which is the hallmark of hammertoe. The other conditions involve different patterns: claw toe adds hyperextension at the base of the toe plus bending at multiple joints; a Tailor’s bunion is a bony prominence at the side of the fifth toe; foot drop is a weakness causing inability to lift the foot.