Hammertoe correction
Hammertoe correction is a surgical procedure aimed at addressing the painful deformity known as hammertoe, which typically affects the second toe. This condition often arises due to factors such as muscle weakness, ill-fitting footwear, particularly high-heeled shoes, or underlying health issues like diabetes that can damage nerves and muscles. The surgery involves several steps: patients receive a local anesthetic, and a tourniquet is applied to manage bleeding. An incision is made to access and sever the tendons, allowing the toe to straighten. The joint is then stabilized using pins and wires to prevent further bending, and sutures are applied to close the incision.
Recovery from hammertoe surgery requires patients to wear comfortable shoes and avoid vigorous activity for several weeks. While the expected outcome is a normal toe position and relief from pain, patients should be aware that the movement of the affected toe may be limited post-surgery. Potential complications include excessive bleeding and infection, which are important considerations for anyone contemplating this procedure. Overall, hammertoe correction can offer significant relief for those suffering from this painful condition.
Hammertoe correction
Anatomy or system affected: Blood vessels, bones, feet, musculoskeletal system, nervous system, tendons
Definition: The surgical removal of ligaments and joining of the middle joints in the toes to correct hammertoe, a deformity in which the toes bend downward abnormally
Indications and Procedures
A hammertoe is a painful deformity that usually affects the second toe. The clawlike appearance of the toe results from malignancy of the joint surface or shortening and weakening of the foot and toe muscle. People with diabetes mellitus are prone to hammertoe development because of the nerve and muscle damage frequently associated with the disease. In other cases, hammertoe results from the wearing of shoes that are too short and do not fit properly. High-heeled shoes, which place pressure on the front of the foot and compress the smaller toes tightly together, can contribute to hammertoe formation. Painful calluses form on the tops of toes when the deformed toe rubs against the top of the shoe. Special orthotics and pads are often used to redistribute pressure and relieve pain. In severe cases, surgery may be required.
Before the operation, blood and urine studies are conducted, and X-rays are taken of both feet. Hammertoe correction surgery begins with the injection of a local anesthetic. To prevent bleeding in the surgical area, a tourniquet is applied above the ankle. An incision is made through the skin above the affected joint. The tendons that attach to the toes are located and cut free of the connective tissue to the foot bone. The tendons are then divided, enabling the toe to straighten. To keep the toe from bending, the middle joints are permanently connected together with fine pins and wires. Fine sutures are used to close the skin, and the tourniquet is removed. After the surgery, additional blood studies are taken. Sutures are usually removed seven to ten days after the procedure.
Uses and Complications
The correction of hammertoe usually arises from a need to correct a severe deformity or relieve persistent pain. During recovery, flat, comfortable shoes should be worn. After recovery, patients should wear shoes that fit well and do not cramp the toes or put undue stress on the front of the foot. Though full recovery from surgery is expected in four weeks, vigorous exercise should be avoided for six weeks after surgery. Once the time for healing has passed, the affected toe will appear in a normal position, and pain will be relieved. Because of the connecting of joints in the toe, however, movement of the toe will be limited.
Possible complications associated with hammertoe correction include excessive bleeding and surgical wound infection.
Bibliography
A.D.A.M. Medical Encyclopedia. "Hammer Toe Repair." MedlinePlus, July 14, 2012.
Copeland, Glenn, and Stan Solomon. The Foot Doctor: Lifetime Relief for Your Aching Feet. Rev. ed. Toronto, Ont.: Macmillan Canada, 1996.
Currey, John D. Bones: Structures and Mechanics. Princeton, N.J.: Princeton University Press, 2002.
FootCareMD. "Hammer Toe." American Orthopaedic Foot and Ankle Society, 2013.
"Hammer Toe Correction." Health Library, May 2, 2013.
“Hammertoe and Mallet Toe - Diagnosis and Treatment.” Mayo Clinic, 6 Apr. 2023, www.mayoclinic.org/diseases-conditions/hammertoe-and-mallet-toe/diagnosis-treatment/drc-20350845. Accessed 22 July 2023.
Lippert, Frederick G., and Sigvard T. Hansen. Foot and Ankle Disorders: Tricks of the Trade. New York: Thieme, 2003.
Lorimer, Donald L., et al., eds. Neale’s Disorders of the Foot. 7th ed. New York: Churchill Livingstone/Elsevier, 2006.
Van De Graaff, Kent M., and Stuart I. Fox. Concepts of Human Anatomy and Physiology. 5th ed. Dubuque, Iowa: Wm. C. Brown, 2000.