The Center for Podiatric Care and Sports Medicine

When Medicine Isn’t Enough: Get Rid of Hammer Toe With Surgery

Posted by on Tuesday, August 13th, 2013

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Most commonly, people elect to have hammer toe surgery when the pain becomes unbearable or when their feet have trouble fitting into shoes. Early intervention may include wearing supportive shoes with improved arch support and wider toe boxes.  Anti-inflammatory medicines and physical therapy may be used to reduce inflammation. Cortisone shots can decrease pain and swelling as well. Toe splints or pads can lessen the pain or stall hammer toe progression. If these conservative treatments do not work, then hammer toe surgery may be recommended.

Internal Fixation and Decompression

Over the years, fixation techniques have changed significantly. Kirschner wires have been the standard method of fixation for the past 30 years. This involves inserting a metal pie into the toe to stabilize the joints. Later, the metal piece is removed once the deformity has straightened out.

However, this procedure is not without its criticisms. While rare, there is a possibility of infection getting into the body through the open wound. A bigger problem can be the psychological barrier faced by the patients who dislike the idea of pins protruding from the toe and who often fear they will stub their toe, thereby pushing in the pin. There have been some cases of snagging the pins and pulling them out by accident, as well as complaints of persistent stiffness.

The good news is that proper positioning of the K wire can minimize pain and discomfort. On top of that, newer fixation methods like resorbable rods, bone staples, screw fixation, allograft bone pins and metallic systems like Pro-Toe, Smart Toe and StayFuse (pictured below) were designed to correct mild and moderate deformities without any portions protruding externally.

Metatarsal Surgery

Podiatry Today reports that metatarsal reduction in hammer toe surgery used to be considered taboo by the medical community, unless used to treat the most serious hammer toe deformities. Yet, there has been a shift in thinking and metatarsal shortening procedures are considered one of the primary surgical interventions to correct hammer toe these days. Removing a portion of at the contracted joint to realign the toe is an important part of preventing a recurrence by addressing the underlying structural issues.

Hammer Toe Surgery Recovery

Hammer toe surgery is an outpatient procedure that does not require a hospital stay. Healing takes place in about six weeks for healthy people. Patients often return to normal shoes and activities anywhere from two weeks to three months, depending on the severity of the hammer toe deformity and which toes were affected. The fourth and fifth toe surgeries generally lead to a quicker return to walking in regular shoes, as these toes are not used for propulsion as much as the first, second and third toes. Dr. Geldwert will work with you to determine how to do the most minimally invasive surgery with the quickest recovery time, given your unique situation.

 

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.