Once the closest bone closest to the foot (proximal phalanx) is pulled upward by the tendons on top of the foot and then remaining part of the toe (intermediate and distal phalanx) pulled downward by the tendons on the bottom of the foot, the mechanical advantage keeps the toe in that position.
In that position, the top of the joint can rub on shoes to create the callus or quintessential "corn".
Custom molded orthotics can help the toe gripping portion of the hammer toe during standing and walking, but surgery is required to fix this problem.
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