HAMMERTOE CORRECTION

General Information

DEFINITION--Removal of tendons and joining of middle joints in the toes to correct hammertoe, a deformity in which the toes bend downward. This causes the tops of the toes to become callused from rubbing against the inside of shoes. Hammertoe probably results from wearing shoes that do not fit properly, especially high-heeled shoes that place pressure on the front part of the foot and compress the smaller toes together tightly.

BODY PARTS INVOLVED--All toes except the big toes; tendons, blood vessels and nerves connected to these toes; overlying skin.

REASONS FOR SURGERY

• Relief of painful calluses.
• Prevention of permanent deformity.

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Excess alcohol consumption.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--General surgeon (sometimes), podiatrist or orthopedic surgeon.

WHERE PERFORMED--Hospital or outpatient surgical facility.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of feet.
• After surgery: Blood studies.

ANESTHESIA--Local anesthesia by injection.

DESCRIPTION OF OPERATION

• After local anesthesia is injected, a tourniquet is applied above the ankle to keep the surgical area from bleeding.
• An incision is made through the skin.
• The tendons that attach to the toes are located, cut free of connective tissue to foot bones, and divided so they no longer bend downward.
• The middle joints of the affected toes are connected together permanently with fine pins and wire sutures.
• The skin is closed with fine sutures, which usually can be removed about 7 to 10 days after surgery. The tourniquet is removed.

POSSIBLE COMPLICATIONS--Excessive bleeding or surgical-wound infection.

AVERAGE HOSPITAL STAY--None.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 4 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
• Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain.
• Bathe and shower as usual. You may wash the incision gently with mild unscented soap.
• Wear shoes that fit well and do not cramp the toes or put undue stress on the front of the foot.
• While healing, wear flat shoes and white cotton socks.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

ACTIVITY

• Avoid vigorous exercise for 6 weeks after surgery.
• Resume driving 1 week after returning home.

DIET---No special diet.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience new symptoms such as nausea or vomiting.