What are Hammertoes?
Hammertoes occurs when crops are curled as a result of a bend in the middle joint of the toe. It usually happens at the second, third or fourth toes and is sometimes referred to as contracted toe or rotated toe, or misnamed as claw toe, which is a different condition. It usually happens as the tendons at the top and bottom of the toes become imbalanced and pull the toe (s) into the hammer position. When the toes are bent in this way, the result resembles a hammer shape, giving the name hammertoe. A variety of biomechanical issues in the feet can cause tendon imbalance.
People with hammertoes may have corn and calluses form on the top of the middle joint of the toe, or on the tip of the toe. There can be swelling and redness around the toes and stiffness can make it difficult to walk. Individuals with hammertoe may feel persistent pain when on their feet. Hammertoe surgery may be required to treat this pain.
Hammertoes can be flexible or rigid. Flexible hammertoe can be manually corrected and may respond to conservative treatment like foot orthotics to correct biomechanical insufficiencies. Rigid deformity would require hammertoe surgery for correction. However, accommodation of the deformity may be possible using appropriate footwear or foot orthotics.
Hammertoe Surgery: What is the Process?
There are several types of surgeries used to correct hammertoes. Some surgeries may require general anesthesia while others are completed safely under local anesthesia. In most cases, hammertoe surgery can be done during the day and you will not have to stay overnight at the hospital. The foot and prepared and a small incision is made. Your surgeon will be using small tools to work in this delicate area of the foot.
Types of Hammertoe Surgery
The most common types are:
- Tendon transfer
- Arthrodesis
- Arthroplasty
Tendon transfer involves re-routing the tendon from under your toe to the top of the toe to correct the position. This surgery is often chosen if the toe is mobile. Otherwise, it can be used in combination with the following procedures.
Digital arthrodesis involves straightening the toe and fusing the joint completely. The surgeon inserts a wire into the toe that extends past the end of the toe to hold it in place for around 3-6 weeks.
Implant arthroplasty , or joint replacement is the third option. Here an implant made of silicon, rubber or metal is inserted in the toe to act as a replacement for the removed bone.
What to Expect After Hammmerte Surgery
After having hammertoe surgery, you can expect to have some swelling, stiffness and limited mobility. For some it can take as long as 8-12 weeks to be walking normally again while others can walk immediately after surgery. According to the surgeon, which surgery they performed and the way they did it, instructions after hammertoe surgery will differ … so follow the surgeon's instructions to the letter. A typical recommendation could involve restriction of weight bearing for 24 hours after surgery, a splint for 2-4 weeks, and continued wear of appropriate footwear. Exercises to increase the strength in the foot and toe muscles may also be suggested.
What Are The Risks Of Hammertoe Surgery?
There is a risk of infection with any surgery. Your toes may swell for long periods following hammertoe surgery. Nerve injury, numbness, limited range of motion, or extended periods of pain may occur. There is also no guarantee that the procedure will work in every case and the deformity could return.
Options to Avoid Hammertoe Surgery
There are more conservative approaches to relieving pain from hammertoes. Using splints to realign the affected toe may take away your need for hammertoe surgery. Protective padding on corn and calluses can alleviate pain as well. Perhaps the most important is choosing the correct footwear by selecting shoes that have proper support and a wide toe box so they do not rub and irritate the toe at the problem area.
Wearing foot orthotics designed to relieve the pressure on your toe deformity and increase your biomechanical efficiency can also be effective. If the hammertoe deformity occurred because of improper positioning of your foot, orthotics can be important to control foot position after your surgery so the hammertoe deformity does not return.
Your physician will take many things into consideration before suggesting hammertoe surgery. If your toe is very painful, your condition interferees with your daily activities, and more conservative treatments have not proven successful, hammertoe surgery may be necessary. It will also be suggested more readily if you have a strict rather than flexible deformity.