Hammertoe surgery

Hammertoe surgery: Digital deformities of the foot are frequently observed and are commonly termed ‘hammertoes’. The condition involves changes consistent with osteoarthritis in the small phalangeal joints of the toes. Often, the primary cause of discomfort is due to callous build up and footwear irritation.

Hammertoe surgery may be indicated when conservative measures fail. Hammertoe surgery can be performed simply under local anaesthetic, or in a hospital environment under general anaesthetic.

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Causes

  • Poorly fitting shoes: usually wearing shoes that are too short
  • High Arched foot
  • Genetics
  • Bunion deformity
  • Rheumatoid arthritis
  • The underlying neurological conditions such as Charcot Marie Tooth disease
  • Diabetes
  • Tendon imbalance due to faulty foot biomechanics

Symptoms

  • Pain or irritation when wearing shoes.
  • Corns and calluses on the toe, between two toes, or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending on their location.
  • Inflammation, redness, or a burning sensation
  • Contracture of the toe
  • In more severe cases of hammertoe, the breakdown of the skin happens to cause an ulcer.

Diagnosis

The diagnosis of digital deformities is made purely through clinical assessment although x-rays may offer further information regarding bone and joint pathology. Digital deformities may include: ›

  • Hammertoes ›
  • Claw toes ›
  • Mallet toes ›
  • Flexible [all of the above] ›
  • Rigid [all of the above]

Conservative Management

  • Depends largely on patient expectations
  • Initial therapy may be conservative such as adjusting footwear
  • Ortho-digital  splinting therapy may be helpful in weight re-distribution
  • Regular lesion debridement may be useful in alleviating symptoms

Surgical Management

  • Minimal incision surgery (Flexor tenotomy) for flexible claw and mallet toes
  • Toe arthroplasty  – Toe arthroplasty refers to removing a small amount of bone from one or more joints of a toe
  • Toe arthrodesis refers to removing the cartilage within a joint and holding the bones together with an internal implant so that they become one bone after 6 weeks. No more external wire in your toe for 4 weeks!
  • Flexor tendon transfers

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner

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