Mallet Toes, Hammertoes, Neuromas, and Metatarsophalangeal Joint Instability: 40 Years of Development in Forefoot Surgery

  • Debbie Y. Dang
  • Michael J. CoughlinEmail author
Review Article



Today’s foot and ankle surgeon has an enhanced understanding of forefoot pathology and treatment options compared to surgeons who practiced in previous decades. This paper summarizes developments in forefoot surgery in the past 40 years, specifically in treatments for mallet toe, hammertoe, neuroma, and metatarsophalangeal joint instability.

Materials and Methods

A review of the literature was conducted using the PubMed search engine, with key terms including, “mallet toe,” “hammertoe,” “neuroma,” “metatarsophalangeal joint instability,” “plantar plate,” and “forefoot surgery.” Chapters in major orthopaedic textbooks covering these topics were also reviewed. We then chronicled the history of the diagnosis and treatment of these pathologies, with a focus on the past 40 years.


There have been major advances in understanding and treating forefoot pathologies in the past four decades; however, there remain areas for improvement both in the diagnosis and treatment of these problems.

Level of Evidence

Level V, meta-synthesis.


Mallet toes Hammertoes Morton’s neuroma Metatarsophalangeal joint instability Forefoot surgery 


Author Contributions

This manuscript has been read and approved by all authors and represents honest work. Both authors contributed to the writing of this manuscript.



Compliance with Ethical Standards

Conflict of Interest

The senior author, MC, has consulting relationships with Stryker & Arthrex, whose implants are referenced in this paper. The lead author, DD has no conflicts of interest.


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Copyright information

© Indian Orthopaedics Association 2020

Authors and Affiliations

  1. 1.Saint Alphonsus Medical Group, Department of Orthopaedic SurgeryCoughlin Foot and Ankle ClinicBoiseUSA

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