Understanding Hammertoe Surgery: A Guide for Patients
Hammertoe is a condition that causes one or more of the smaller toes to bend down at the middle joint, creating a shape that looks like a hammer. This can cause pain, difficulty finding comfortable shoes, and the development of calluses. When conservative treatments like shoe adjustments or padding don’t work, surgery may be needed to correct the problem.
What Happens During Hammertoe Surgery?
When surgery is necessary for a hammertoe, the main goal is to straighten the bent toe and relieve the pain. The most common surgical technique for a fixed hammertoe (where the toe is stuck in a bent position and can’t straighten out) is called PIP joint resection arthroplasty or fusion. Here’s how the surgery works:
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Positioning the Patient: The patient is made comfortable on their back (lying down) under anesthesia, either general (fully asleep) or a regional block (numbing the area).
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Making the Incision: The surgeon makes a small cut on the top of the toe, right over the bent joint (called the PIP joint).
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Exposing the Joint: The surgeon removes the soft tissue (skin, tendons) to get to the toe joint. They might also remove any thickened skin (calluses) that can form over time.
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Releasing the Ligaments: The surgeon cuts the ligaments and tissues around the joint to free up the area and make it easier to realign the toe.
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Resecting the Joint Surfaces: The top and bottom parts of the joint are carefully removed using special tools. This helps to straighten the toe.
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Aligning the Toe: The toe is then positioned straight, and a small metal wire (called a K-wire) is inserted to hold it in place while it heals. This wire stays in the toe for several weeks.
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Closing the Incision: The incision is stitched up, and the toe is wrapped in a soft dressing to protect it during recovery.
What Happens After Surgery?
After the surgery, patients are usually told to wear a special shoe or boot to protect the toe as it heals. Most people can begin walking gently on their heel within a few days. Regular follow-up appointments are needed to check on the healing process.
The K-wire is typically removed after 3 to 6 weeks. This helps keep the toe in the correct position while it heals. Patients will also have stitches removed around the same time.
Results: What Can You Expect?
For most people, hammertoe surgery is very successful. Studies show that about 92% of patients experience pain relief after surgery. Also, 84% of patients are satisfied with the final results, reporting that their toe looks and feels much better. However, like with any surgery, there can be some risks, including:
- Infections around the surgical site (but these are rare and can usually be treated easily)
- Recurrent deformities where the toe may start to bend again (this can sometimes be fixed with minor procedures)
- Numbness in the toe after surgery (this might go away with time)
Complications to Watch For
While serious problems are rare, some people may experience issues like misalignment of the toe, or it might bend again (a condition called recurrent deformity). If this happens, the problem can usually be fixed with additional surgery, like tendon release or small adjustments.
Other Fixation Options
In the past, K-wires were the go-to solution for holding the toe in place during healing. However, newer methods using permanent implants like screws or special memory metal devices are becoming more common. These devices might provide even better results, especially for patients who need additional surgeries due to recurring problems.
Final Thoughts
Overall, surgery for hammertoe is a highly effective treatment for people whose condition does not improve with nonsurgical methods. Most patients experience significant pain relief and improved toe alignment. The procedure is safe with a low risk of complications, and most people are very happy with the results. If you are considering surgery, it’s essential to discuss all the options with your surgeon to choose the best treatment for your specific needs.
Do you have more questions?
Q. What is Hammertoe Surgery?
A. Hammertoe surgery is a procedure used to correct a hammertoe, a condition where one or more smaller toes bend downward at the middle joint, causing pain and difficulty finding comfortable shoes.
Q. How is Hammertoe Surgery performed?
A. During the surgery, a small incision is made over the bent joint, the ligaments and tendons around the toe are released, and the joint is resected to straighten the toe. A K-wire may be inserted to hold the toe in place while it heals.
Q. What is the recovery process after Hammertoe Surgery?
A. After surgery, patients wear a special shoe or boot to protect the toe. Most people can begin walking gently on their heel within a few days, and the K-wire is removed after 3 to 6 weeks.
Q. What are the expected results of Hammertoe Surgery?
A. Approximately 92% of patients experience pain relief, and 84% are satisfied with the final results, reporting improved toe appearance and function. However, risks include infections and the possibility of recurrent deformities.
Q. Are there alternative fixation options besides K-wires?
A. Yes, newer methods include the use of permanent implants like screws or special memory metal devices, which may provide better long-term results, especially for patients with recurring problems.
Q. How long does the Hammertoe Surgery procedure take?
A. The surgery typically takes about 30 minutes to an hour, depending on the severity of the condition and the specific technique used.
Q. Is Hammertoe Surgery a safe procedure?
A. Yes, Hammertoe Surgery is generally safe with a low risk of complications. However, there are some risks, such as infection and misalignment, which can usually be corrected with additional treatment if needed.
Q. Will I need physical therapy after Hammertoe Surgery?
A. Physical therapy is often recommended to help regain toe mobility, strength, and flexibility after surgery, as well as to reduce stiffness and prevent complications.
Q. How long will I be unable to walk normally after Hammertoe Surgery?
A. Most patients can start walking gently with a special shoe within a few days. However, full weight-bearing activity should be avoided for several weeks to ensure proper healing.
Q. Can Hammertoe recur after surgery?
A. While the surgery is successful for most patients, in some cases, the toe may start to bend again (recurrent deformity). This can be treated with additional minor procedures if necessary.
Q. Is Hammertoe Surgery appropriate for everyone?
A. Hammertoe surgery is typically recommended for patients who have persistent pain or difficulty walking due to a hammertoe, especially after conservative treatments like orthotics or physical therapy have failed.
Q. Will my toe look different after Hammertoe Surgery?
A. Yes, the goal of the surgery is to straighten the bent toe, which can significantly improve its appearance, making the toe look more natural and reducing any visible deformities.
Q. Can I drive after Hammertoe Surgery?
A. It is generally advised not to drive for at least 2 to 4 weeks after surgery, particularly if the surgery was on the right foot or if you require a walking boot or crutches.
Q. How much pain can I expect after Hammertoe Surgery?
A. Most patients experience mild to moderate discomfort after surgery, which can be managed with pain medications and elevation. Swelling and bruising are common in the first few days.
Q. Can Hammertoe Surgery be performed on both feet at the same time?
A. In some cases, Hammertoe Surgery can be performed on both feet simultaneously, but it is typically done one foot at a time to ensure proper healing and reduce the risk of complications.
Dr. Mo Athar
