Claw, hammer and mallet toes are toe deformities, were metatarsophalangeal and/or interphalangeal joints of the lesser rays are affected.

Such deformities may be flexible or stiffed, which has an implication in the treatment options.

The picture illustrates a rheumatoid foot, that has a severe bilateral Hallux Valgus, and claw toe deformity of the lesser rays.

When the metatarso-phalangeal joint is affected, it is necessary to rebalance and decompress it, which demands soft tissue release and frequently a metatarsal shortening osteotomy.

In the present case, despite the rheumatoid arthritis, a joint preserving surgery was chosen, with shortening metatarsal osteotomies and one head subtraction osteotomy, with removal of the segment with cartilage loss.