Toe deformity Mallet toe 2025-08-12T07:34:50Z A mallet toe involves the distal interphalangeal (DIP) joint [such that] the distal phalanx is flexed on the middle phalanx. The etiology of mallet toe is varied, and has been attributed to anatomy and toe length, shoewear, trauma, or a factor in systemic neurologic disease. With a fixed mallet toe deformity, patients often complain of pain at the dorsal DIP joint, and/or pain at the tip of the affected toe, where undue pressure from footwear and weight bearing is experienced. Calluses may be found at either of these locations. When symptoms can no longer be tolerated with treatments such as modified shoewear and padding in a patient without underlying systemic disease, surgical intervention may be indicated.