Hammertoe basically is a deformity which causes toes to become bent upwards in middle so that they resemble a hammer. Hammertoes are often found to occur in conjunction with various other toe problems. It is also possible for hammertoe patients to develop corns on top of the middle joint of hammertoe. People having hammertoes generally try to manage them by trying to treat symptoms. Treatments for managing hammertoes involve padding the toe & stretching or changing shoe-wear for comfort. If patients still experience discomfort due to hammertoe, it may be ideal that they consider surgery for treatment. Hammertoes can either be flexible or stiff. Several different types of surgeries can be utilized to treat hammertoes depending upon the flexibility of toe & preference of the operating orthopedic foot & ankle surgeon.
Hammertoe surgery is generally performed as an outpatient procedure which effectively treats abnormal curves or bends found in the middle joints of toes. This type of deformity most often makes movement of the affected toe quite painful & difficult. Quite often the affected toe is found to rub against the inside of shoes & thereby resulting in corns & calluses which end up causing additional discomfort. Conservative treatments like as orthotics & exercises to strengthen toes often fail to ease associated discomfort. In such cases hammertoe surgery is quite naturally the best option. Orthopedic surgeons will make small surgical incisions on the affected toe & use surgical instruments which allow them to get inside the toe for repair in order to complete the surgical intervention. Although various types of surgeries are available for hammertoe correction, most operations typically involve straightening, cutting or removing parts of the joints, bones and/or tendons of the toe in order to realign connective tissue to foot bones. Incisions may be additionally required in order to prevent the toe from bending downwards. Surgical hardware required in the process includes pins or wires which may be put inside toes so as to aid the healing process. Small sutures are subsequently utilized to close surgical incisions which are typically removed 7 – 10 days following surgery.
It is possible that some people are born with hammertoe. However, many people are found to develop this deformity later in life. Nevertheless, common causes of development of hammertoe include the following.
Most people realize that they are having advanced hammertoe deformity only after they have tried conservative treatments like orthotics & toe strengthening exercises which have failed to relieve pain. Patients with advanced hammertoe may experience cramping or stiffness in toes, pain in the middle joint or base of their toes or may experience toe and/or foot pain which affects their ability to walk properly. In order to determine whether hammertoe surgery is the ideal course of treatment, orthopedic surgeons will usually enquire about symptoms & medical history of patients. Physical examination of toes will also be performed & X-rays may also be taken. Hammertoe surgery is most often recommended for people with advanced hammertoe deformity in order to delay progression of this condition & diminish discomfort.
There are several surgical techniques which are available to control hammertoe deformity. Doctors will decide which method would be most effective as treatment depending upon the severity of deformity, direction of the toe’s deviation & length of the toe which is affected. Some of the most common surgical techniques include the following.
Although hammertoe pre-surgery instructions may often vary from patient to patient, orthopedic surgeons will most likely request patients that they arrive at the hospital or outpatient facility at least one or two hours prior to the time of operation. Patients will first have to fill out forms & get admitted & then they will eventually be evaluated by anesthesiologists. Local or regional anesthesia is the normal choice meaning that patients will remain awake during surgery as most hammertoe operations are performed under the ankle block. Quite a few patients may however receive general anesthesia & will therefore sleep through the surgical intervention procedure. Depending upon the type of anesthesia which will be administered to the patient, they may not be able to eat or drink or take certain medications prior to undergoing hammertoe surgery. Often, hammertoe patients are also given sedatives before the procedure in order to help them relax during the operation. Therefore, it is important for patients to arrange for someone to drive them back home after operation since the effects of sedatives most often take some time to wear off. Orthopedic surgeons will also provide specific instructions to hammertoe patients prior to surgery so that they can prepare accordingly.
Patients will be moved to a recovery room after completion of hammertoe surgery. Moreover, most of the patients are generally sent back home after they have rested for a few hours. However, when hammertoe surgery patients are discharged their foot will be bandaged & they will also be provided with a protective surgical shoe so as to enable them walk following the surgical procedure. Redness, swelling, stiffness & discomfort are invariably common for several weeks after hammertoe surgery. Nevertheless, pain is usually easily managed with the help of prescribed medications. In case hammertoe surgery patients experience persistent numbness, burning sensation or tingling in ankle or foot which is not comforted by elevation or icing, must essentially call upon the surgeon for help. Full recovery however, typically takes anywhere between 1 – 3 months time & is largely dependent upon which toe was operated upon & how well has the patient followed postoperative instructions provided by the surgeon. Even though specific instructions often vary from patient to patient & will also be specific to the type of hammertoe surgery which has been performed, there are a number of common precautions which orthopedic surgeons will most likely suggest in order to ensure proper healing of the operated toe. Some of these instructions are listed below.
Certain activities may be difficult or unsafe for people who have recently undergone hammertoe surgery. Some of these common activities are listed below.
Possible complications following hammertoe correction surgery generally relate to surgery. These include infection, bleeding, damage to nerves & blood vessels, blood clots & risks relating to administration of anesthesia. Complications which are specific to hammertoe repair surgery include a small chance that hammertoe deformity may be able to come back after surgery. Another risk is that patients may feel that the toe is unstable after the operation. This feeling is largely due to cutting of tendons & ligaments in specific cases. However, this risk is also small as pins are most often used to hold the toe in place for a few weeks during the healing period. For hammertoe deformity patients undergoing fusion technique involves a small risk of bones not healing properly following surgery. But then these complications are very rare. Patients must therefore discuss these potential complications with orthopedic surgeons prior to undergoing hammertoe correction surgery.
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