Hammertoes surgery complications

Written by bonnie bruneau
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Hammertoes surgery complications
(Northcoast Footcare: Flickr.com)

Hammertoe is a condition in which a smaller toe projects outward or upward and becomes bent. The metatarsals--long foot bones--form a joint with the toes, or ball of the foot. A deep blister can develop over the joint and lead to bursitis (inflammation). Over time, the skin can harden over the joints or tip of the toe. Hammertoe surgery corrects a bent toe but there are several possible complications to consider prior to having an operation.

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Pain and Swelling

It is typical to experience pain and swelling with any surgery and foot surgery is no exception. After hammertoe surgery, you can ease the pain and discomfort from swelling and inflammation by elevating your foot and leg. Try lying down with the affected foot on a pillow. Avoid being overly mobile during the first few days to keep swelling from increasing. However, always follow your doctor's instructions.

Another possible complication is for the toe or foot pain to become permanent. There might also be nerve pain, which may or may not go away in time. It is also possible to have discomfort in other parts of the foot during recovery, which usually subsides.

Infection and Blood Clot

Infection, another complication of hammertoe surgery, poses only a small risk. When it does occur, it is most often superficial and around the wound. Antibiotics are used in a case of infection. It is possible, although rare, to experience a serious, deeper infection involving the bone (called osteomyelitis). Treatment might include IV antibiotics, a hospital stay and a lengthy dose of oral antibiotics. It can be fatal if not treated early.

A blood clot, or deep vein thrombosis, is also a potential complication after hammertoe surgery because the foot remains immobile while recovering. Blood clots can be prevented and/or treated with blood thinners or further surgery.

Floppy/Flail Toe, Floating Toe and Mallet Toe

Floppy/flail toe, floating toe and mallet toe are all hammer toe surgery complications.

A floppy toe, or flail toe, causes it to feel as though the toe has lost function and is "floating" or "flailing" around. It can be uncomfortable to put on socks. Floppy toe can occur when a lot of bone is surgically removed. It may be corrected with further surgery or the toe may possibly need to be amputated. Also, toe stiffness may occur.

A floating toe may not sit or rest on the floor. There is an increased risk of this with arthrodesis, or surgical fusion of a joint for pain relief.

A mallet toe deformity may occur over time. With a mallet toe, you cannot straighten the joint at the end of the toe. If the mallet toe rubs too much against the top of a shoe, pain and/or a corn can develop.

Delayed Healing and Non Union

Healing times can vary. The skin or bone may take months to heal or possibly never heal the way it should (called non union). The risk is less for those who do not smoke. Non union may or may not be painful. Sometimes, it can be treated with further surgery, where the spot of non-healing bone is replaced with healthy bone from another area (called bone grafting).

Chronic Regional Pain Syndrome

Chronic regional pain syndrome is a possible hammertoe surgery complication. It is a rare condition where the body has an overreaction to the injury (surgery) and extreme sensitivity and pain occur as a result. Any light touch or movement can be debilitating and excruciating. Early treatment by a special pain clinic can help

Scarring

Scars occur in any surgery and healing times can vary. It is possible for scars to be painful, entrap nerves, experience discolouration and/or thicken (called keloid scars), all of which are potential hammertoes surgery complications.

Recurrent and Ongoing Complications

The hammertoe deformity and/or corn can reoccur. It is most problematic with the little toe.

If swelling and discomfort linger, wearing shoes can cause ongoing difficulty. Some people may be unable to wear stylish shoes, as they tend to be less comfortable and supportive.

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