Overview

Hammer or claw toes are the most common toe deformities and can cause problems in a number of ways.  They often require surgery as they can cause problems relating to the prominent knuckle joint on the toe sticking up and rubbing on your shoe, causing wear and corn formation or ulcers. The deformity of the toe itself may cause pain from inflammation in the main joint at the base of the toe or because of damage and stretching of the ligament under the toe and ball of the foot. You can feel as if you are walking on a pebble.

Hammer toe can be genetic, caused by wearing too tight shoes, the result of the presence of a bunion, from a neurological cause, from rheumatoid or other types of arthritis, overuse and ligament damage or simply be the particular shape of your foot.

Non-surgical methods of treatment should always be considered before surgery.  Orthotics and insoles may be an option to assist with pain under the ball of the foot; taping or strapping the toe may prevent ligament damage; silicone sleeves or padding over the toe may cushion it and an appropriate wide and roomy shoe selection will prevent further pressure.

If these measures fail to work then surgery can be performed to straighten the toe.

Process

Surgery can involve a number of small procedures depending on the problem.  Usually the bent knuckle in the middle of the toe will need to be straightened and possibly fused. This is performed as day surgery unless it is combined with treatment for a bunion or other problems which may require an overnight stay.

You may require a pin in the toe which is left 5mm outside the toe and removed after 4-6 weeks.  Removal of the pin is straightforward and takes just a few seconds with no need for anaesthetic.  Sometimes a dissolvable pin or internal pin can be used instead.  Other adjustments include lengthening tight tendons or shortening the Metatarsal head (knuckle bone at the bottom of the toe joint).

Weight bearing is allowed in a post-operative sandal. Elevation is required for 5-7 days and you can expect to be mostly recovered by 4-5 weeks once the bones are healing. The toe can remain swollen for several months however it will recover.

Some stiffness may occur in the toe following surgery. This is normal and cannot be helped as the previous damage cannot be fully corrected. However the toe will be straighter and more comfortable.