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What is
Hammertoe Correction?
A surgical procedure to correct a foot
deformity called a hammertoe. This deformity
occurs when there is a shortening of the
tendon that controls toe movement, causing
the middle joint of the toe to be bent
upward and the distal joint downwards. The
misshapen toe resembles a hammer.
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Effects
of Hammertoe Correction
Non-operative treatment of hammertoe
deformity often successfully alleviates
pain; however, the deformity typically
progresses in magnitude and stiffness in
most cases in spite of diligent
non-operative care. Surgical treatment of
flexible hammertoe deformity reliably
corrects the deformity and alleviates pain.
Recurrence and progression are common;
however, especially if the patient resumes
wearing deforming shoes. Surgical treatment
of fixed hammertoe deformity provides very
reliable deformity correction and pain
relief. Recurrence is rare.
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Candidates
for Hammertoe Correction
The indication
for surgical treatment of hammertoe
deformity is disabling pain that does not
improve with adequate non-operative
treatment, including taping for flexible
deformity and using accommodative footwear
with a toe box of adequate depth for fixed
deformity.
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Your
Consultation
Prior to the
procedure, your doctor will likely do the
following: Physical exam and X-rays of
joint. The day of the procedure, arrange for
a ride to and from the procedure, arrange
for help at home after the procedure and
wear comfortable clothing that is easy to
remove.
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The Hammertoe Correction
Procedure
There are two common methods of hammertoe
correction: joint arthroplasty and joint
fusion. The type of procedure used depends
on the severity of the deformity.
For both
methods, the doctor makes a cut on the toe.
During an arthroplasty, the largest part of
the middle joint in the toe is removed,
which allows the toe to uncurl. One or more
bones or a part of the bone may be removed
as well. During a fusion, the bones are
repositioned after ends of the bone at the
joint are resected and the bones are put
together. The repositioning is usually held
together with a pin placed within the bone,
and this pin will be removed after 3-4
weeks. Other changes to the anatomy of the
foot due to the hammertoe may also be
corrected at this time.
The doctor
closes the incision with stitches. These
stitches will be removed in about two weeks,
and the doctor will apply another dressing
to hold the toe(s) in proper position.
Dressings may be reapplied as swelling
decreases, and can usually be totally
removed after a total of four weeks. If it
appears that the deformity may recur, your
doctor may choose to continue with dressings
for another 2-4 weeks.
In people
under age 30 with a mild deformity, a
corrective procedure involving soft tissue
but no alteration to the joint or bones may
be possible.
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Recovery
The corrected
toe may be slightly longer or shorter than
before surgery (depending upon what has been
removed), and will not move as much as a
normal toe. Expect some swelling and
redness, which may persist for several
months.
Select shoes
with plenty of space for your toes. Poorly
fitting shoes contribute to hammertoe
development.
Post-operative care:
·
During the
first couple of days, rest in bed with your
foot elevated; only get out of bed to use
the bathroom
·
Keep your
foot elevated while resting
·
Limit
standing and walking, and stay off your foot
as much as possible
·
use crutches
or wear a special open-toed, wooden-soled
shoe, as directed by your doctor
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Risks
Possible complications are: infection,
Excessive
swelling or bleeding, although the toe will
normally be swollen for 4-8 weeks following
surgery, anesthesia-related problems and
recurrence of hammertoe.
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Frequently Asked
Questions
Q: What is a hammertoe?
A:
A surgical procedure to correct a foot
deformity called a hammertoe. This deformity
occurs when there is a shortening of the
tendon that controls toe movement, causing
the middle joint of the toe to be bent
upward and the distal joint downwards. The
misshapen toe resembles a hammer.
Q: What are the reasons for getting this
procedure?
A:
The malformed toe has assumed an awkward
position and is causing pain, the deformity
makes walking difficult, or the position of
toe causes breakdown of skin, which can
increase the risk of developing a bone
infection (osteomyelitis).
Q: What happens during a hammertoe
procedure?
A:
After local
anesthesia is injected, a tourniquet is
applied above the ankle to keep the surgical
area from bleeding. An incision is made
through the skin. The tendons that attach to
the toes are located, cut free of connective
tissue to foot bones, and divided so they no
longer bend downward. The middle joints of
the affected toes are connected together
permanently with fine pins and wire sutures.
The skin is closed with fine sutures, which
usually can be removed about 7 to 10 days
after surgery. The tourniquet is removed.
Q: What is the probable outcome of this
procedure?
A:
Expect complete healing without
complications. Allow about 4 weeks for
recovery from surgery.
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