Hammertoe impacts the middle toes, causing one or more toes to bend upward at its middle joint, resulting in varying levels of discomfort. Once stiffened into position, a hammertoe can rub against shoes and cause painful corns and calluses. Some individuals with hammertoe have difficulty walking, wearing shoes, and participating in everyday activities.
Lifestyle changes can sometimes help manage this condition, but certain individuals will opt for hammertoe surgery, also known as toe-straightening surgery, to alleviate the pain.
Depending on the severity of the condition, either conservative treatment options and lifestyle readjustments or surgical treatment are necessary to treat hammertoe.
Surgical hammertoe procedures can include joint resection or bone fusion in order to straighten the affected toe or toes. Hammertoe surgery is performed on an outpatient basis, so the patient is able to return home the same day as their surgery.
Before choosing surgery, a number of conservative treatment options are available for those suffering from hammertoe, including the following.
A larger, softer shoe can relieve the direct pressure or pressure from adjacent toes. Make sure that the shoe has enough room at the end (about the width of your thumb) and that the toe box (the front of the shoe) is high enough to allow your toes to move freely.
If a corn or callus has formed, reduction by either professional sharp debridement (shaving) or consistent filing will give temporary relief. Use caution with over-the-counter corn removal medication or pads. This type of medication is a type of acid that can cause an ulceration or infection if not used properly or in excess.
Temporary arch supports or custom molded orthotics can give support and minimize the gripping or clawing effect of toes from a flattening archway. These devices are a good solution for long-term treatment with or without surgical intervention.
In order to remodel and straighten the toe joint, a minimal (0.5 to 1 centimeter) incision is made at the top of the toe. The surgeon will then remove a small portion of the joint in order to fully extend and straighten the toe. To ensure that the toe will remain straight, a small pin is placed in the middle of the toe. Both absorbable and metallic options are available and do not need to be removed.
Another surgical option involves bone fusion. The surgeon goes through the above process, but also fuses together the two bones that create the impacted toe joint. A wire, pins, or screws are inserted to help them fuse together naturally and then removed after healing.
If indicated by the patient in either case, skin lesions and corns can be removed during the procedure. Otherwise they will naturally fall off three to four weeks after surgery.
Surgical hammertoe procedures are performed on an outpatient basis, using a local anesthetic or sedation, and allowing for the patient to return home after the surgery. Patients are advised not to bear complete weight on their foot until 48 to 72 hours of partial weight bearing after the procedure.
Our patient had a common hammer toe and corn problem on her 5th toes that caused pain with her tighter dress shoes. She also had a tight tendon that elevated them above her other toes. The tendon lengthening, hammer toe repair and callus/corn removal was all performed in the office under local anesthesia to both of her feet.
You don't have to live a life of pain. If your hammertoe condition is negatively impacting your daily life, we can help. Contact Moore Foot and Ankle Specialists today and let's discuss whether hammertoe surgery is the right choice for you.
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