A hammertoe is a deformity of the second, third or fourth toe where the toe is bent at the middle joint such that it resembles a hammer. They can result from wearing poorly fitting shoes, as well as other conditions such as osteoarthritis, but are usually resolved with nonsurgical treatment such as physical therapy and switching to more comfortable footwear. However, hammertoe can be corrected with surgery if the deformity is more extreme or symptoms of pain and inflexibility persist even after nonsurgical treatment. Surgery is done on an outpatient basis with a local anaesthetic, and can vary in technique depending on the type and severity of the joint deformity.
Who is a candidate?
Candidates for hammertoe surgery have already exhausted nonsurgical treatment options for the symptoms of hammertoe, and are able to be under local anaesthesia.
Who is not a candidate?
Patients who have not yet exhausted nonsurgical treatment options for hammertoe are not good candidates for surgery. Patients with active infections should wait until the infection has subsided before pursuing hammer toe surgery.
Like other surgeries, hammertoe surgery requires a pre-operative assessment of your toes and overall physical health to ensure that surgery is the best treatment course. You should inform your orthopedic surgeon of any medications or supplements you take, and comply with certain general surgery procedures such as preoperative blood testing and possible cessation of smoking or use of pain relievers and anti-inflammatory drugs one week prior.
Immediately after the procedure, you will likely be given a special shoe to wear in order to aid with walking. You may need to keep your foot elevated at the level of your heart in the first few weeks postoperative in order to prevent swelling. If stitches are used, they will be removed 2-3 weeks after the surgery. At-home exercises may be given in order to stretch and move the toe in order to maintain motion. Although most swelling and pain will subside within a few weeks, it make take up to one year before swelling completely resolves.
As with any surgery, there are risks of complications related to scarring, nerve and vessel damage, infection or adverse reactions to anesthesia. Risks specific to hammertoe surgery include continued symptoms, as well as continued instability and deformity of the toe, although these complications are rare.
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