Hammer toes are common foot problems that turn up in to my foot clinic on a daily basis. Men and women are equally affected and people of all ages. I see more women than men simply because the shoes don’t fit and the toe rubs on top.
So this is a typical story of a hammer toe patient that walks in for a consultation. They all thought only old people get them and its caused by high heels. Most patients can recall feeling pain at the ball of the foot that gradually subsided and they noted that the toe gradually lifted up and then buckled over the next few years.
The initial injury is usually the ball of the foot where the strong ligament like structure called plantar plate becomes inflamed, worn out or torn. This can be because of high heels, injury from running or jumping or simply bad luck. Then the tendons are unevenly balanced because of this weakness and gradually buckle the toe until it becomes a fixed flexion deformity or a toe that does not want to straighten even with force and it can happen to all of the toes. However some people just have a inherent imbalance in the tendons.
So, you can try wearing shoes with a deeper toe box and cushions/splints on toes to protect and prevent them on deteriorating further. Only toe surgery can possible straighten them and it is highly specialised and has had huge interest recently with the development of implants rather than wires sticking out the ends if your toes for 6 weeks like antennas!
Surgical straightening typically consists of either removing the knuckle of the joint and relaxing the ligaments and tendons around the joint or fusing the deformed joint in the straight position. The procedure depends on many factors such as the degree of deformity, the toe itself, quality of bone and the patient. In active people, I prefer to fuse as it provides better long term alignment and function. Over the past few years some of the newer implants such as nextra hammer toe correction systems have allowed me to get my patients back in to shoes quicker with good cosmetic results. After all, who in today’s age can expect to be off for a month especially in a city like London. – By Kaser Nazir – Consultant Podiatric Surgeon