A deformed toe is one of the more common conditions known to afflict the foot, whether it be a hammertoe, mallet toe or overlapping toe.
A hammertoe is a flexible or rigid contraction usually affecting the second, third, fourth or fifth toes. Most often a biome-chanical abnormality results in the larger muscles of the foot and leg overpowering the smaller intrinsic muscles of the foot. Muscle imbalance leads to a bending or "buckling" of the toe joints. These buckled or contracted positions create any number of problems within and on top of the toe deformity. One or more small joints become prominent on top of the malpositioned toe. Tendons, ligaments and joint capsules in that area have a greater chance of tightening and shortening. Shoe irritation of the deformed digit results.in corns, skin inflammation and inability to wear shoes comfortably. If left untreated, these conditions can progress to ulcers or infections.
A flexible hammertoe refers to a reducible hammertoe in contrast to the rigid hammertoe where the deformity is fixed or not easily straightened. There are many causes of ham-mertoes. Some are congenital, hereditary or acquired. An inherited condition may mean an inherited muscle imbalance around the toe or a parent with an abnormally long toe. An acquired hammertoe refers to those caused by short stockings or short/pointed shoes, especially where a long toe is present. Arthritic patients and those with diabetic neuropathy can be more susceptible to hammertoes. Hammertoe surgery in Brooklyn may be necessary, but contact us first so we can help fully analyze your needs.
Conservative treatment can consist of one or more of the following.
1. Trimming, digital splinting and/or padding of the corn.
2. Orthotics or inserts in shoes to correct improper walking.
3. Injections to relieve pain and inflammation.
4. Larger or extra depth shoes to accommodate toe deformities.
If these conservative methods are unsuccessful in treating your deformity, then corrective toe surgery should be considered.
The surgical correction of your toe deformity may be performed in the office, outpatient surgical center or as one-day hospital surgery.
DIGITAL/TOE HAMMERTOE SURGICAL OPTIONS
These procedures help to straighten the toes by cutting the bone, tendon, joints and/or ligaments.
1. TENOTOMY AND CAPSULOTOMY
The terms tenotomy and capsulotomy refer to the cutting of tendons and joint capsules. More specifically in relation to hammertoe deformities, the tight tendons and joint capsules located on the top and bottom of the buckled or contracted toe joints are released.
Once these tight, soft-tissue structures are cut and relaxed, the toe can resume its normal flattened posture.
This very popular procedure involves removal of cartilage and bone in remodeling a deformed joint. It allows for relief of the painful area.
3. ARTHROPLASTY WITH FIXATION FOR FUSION
This procedure involves joint removal and the use of a wire (pin) to stabilize or fuse the deformed toe.
4. ARTHROPLASTY WITH TENDON RELOCATION
A joint space is created and the toe is realigned by relocating the flexor tendon, which pulls the toe down.
5. ARTHROPLASTY WITH IMPLANTATION
Following excision of a joint, a plastic implant is placed inside to act as a functional spacer.
6. DEROTATION/ REALIGNMENT PROCEDURE FOR OVERLAPPING TOE
A wedge of skin and a segment of bone are removed to realign the overlapping toe.
7. BONE SPUR REMOVAL
An incision is made and an instrument is used to file or excise the bone spur and remove the source of increased pressure.
A cut is made through the bone to allow it to be realigned. Wire or pin fixation could be required.
After surgery, you will receive instructions regarding the care of your dressings, your level of activity and weight-bearing. As with all foot surgery, rest and elevation can help reduce pain and swelling.