Causes of Foot Deformity and When Surgery is Recommended

Broadly speaking, causes of foot deformity result from genetic prevalence, as well as possibly poor footwear use and repetitive or acute injuries.

Common Causes of Foot Deformity

The most common causes are usually poor footwear or repetitive trauma, as well as poor genetics, including congenital causes such as bunions and hammertoes, which are caused by genetics.

Hammertoe deformities can be caused by poor footwear-related issues where you’ve worn shoes that are too tight or too short over the years, resulting in pinching of the toes.

Trauma, where you’ve had fractures or torn your ligaments, such as the plantar plate tear, which results in hammertoe deformities, injuries such as Lisfranc injuries, which injure the midfoot, and we develop secondary arthritis, hindfoot trauma, where you can injure the subtalar joint or have fractures within joints that become degenerative over time.

Some medical conditions, such as rheumatoid arthritis and gout, can cause long-term deformities of the feet and joint damage, as well as tendon damage.

When Surgery is Recommended

Usually, surgery is recommended when conservative treatment has failed.

Conservative treatments can include basic things like footwear modifications, using supportive footwear with good support in the heel, good structured shoes with plenty of room to accommodate your feet, and they fit well.

Inserts and orthotic devices can help support the arch and reduce the stress on the feet and lower limb overall. Padding and splinting can be used, alongside physical therapy, to try to strengthen the intrinsic muscles and tendons around the foot and ankle.

However, when deformities become fixed or rigid, they cannot be accommodated in shoes. Once they have developed, they do not usually resolve without surgery, and if they are causing you limitation in your activity, even if it’s sports, general walking or footwear fitting issues, then surgery may be indicated.

Specific conditions related to deformity that require surgical intervention are largely affecting the forefoot, including bunions, hammertoes, arthritis of the big toe joint, and severe flat foot deformities.

Types of Foot Surgeries Often Requiring Surgery

Bunions: This is known as hallux valgus, a deformity of the big toe where the big toe pushes against the second toe. There’s a prominence on the inner side of the big toe bone known as a bunion or hallux valgus deformity. It is corrected via cutting and resetting bones. Newer minimally invasive techniques that Mr Nazir specialises in allow quicker recovery, minimal trauma, and excellent outcomes. Bunions can only be treated via surgical correction.

Post-traumatic Deformities: These are usually fractures or tendon ruptures. These are repaired or corrected by correcting the alignment of the bone and fixing it in position using plates and screws or K-wires.

Hammer Toes: These can be rigid or sometimes reducible; they can be associated with long toes. The toes are straightened by removing the joints in the middle that are contracted and realigning them, so that it improves footwear fitting. These can be done by minimally invasive surgery.

Cavus Foot Type: Cavus foot is a high arch foot type, and often we need to reduce the arch, correct the heel position to prevent recurrent sprains or pain in the heels or the forefoot.

Flat Feet: This can be related to arthritis, congenital issues or even progressive failure of tendons. Sometimes when surgery is required, we have to realign the bones, and the tendon and ligament structures have to be augmented.

Conclusion

Structural foot deformities sometimes require surgery. Many minimally invasive surgical techniques are performed. Please contact the clinic so that we can advise you on the appropriate specialist to see.

Frequently Asked Questions

Q. What are the Most Common Causes of Foot Deformities?

A. Most common causes include congenital or structural development of the foot, which may be due to abnormal mechanics or poor footwear.

Q. Can Shoes Really Cause Foot Deformities?

A. Yes, ill-fitting shoes can result in splaying of the toes or progression of bunion deformities where you’re genetically predisposed.

Q. How do Medical Conditions Like Arthritis or Diabetes Affect Feet?

A. They often can reduce the circulation in your feet, which can result in damage to tissues or genetics, where arthritis, post-trauma or genetics causes the changes in the joints requiring fusion or joint replacement surgery.

Q. When is Surgery Required for Foot Deformity?

A. Surgery is required when conservative treatments fail, and as a last resort, we need to address the problems in the long term. If you have footwear fitting problems, then this surgery may be indicated much sooner.

Q. Can Deformities Get Worse if Left Untreated?

A. Most deformities will get worse and harder to treat as you get older, so early intervention is advisable.