Hammertoe conditions are generally caused by ill-fitting shoes and are predominant in cultures that adorn footwear. Women are much more likely to develop hammertoes than men due to their propensity to wear narrow, high-heeled shoes. This type of shoe can put undue pressure on the toe joint and cause deformity. At times, the condition becomes so painful for the sufferer that surgery is advised. The recovery time from hammertoe surgery is considerable.
Types of Surgery
Advanced cases of hammertoe usually require surgery as they will not straighten out on their own even if causative shoe conditions are discontinued. Three types of operations are available for this condition: tendon transfer, digital arthrodesis and digital arthoplasty.
Tendon transfer involves re-routing of the tendon beneath the toe to above it so it forces the toe joint downward. This is the least invasive method and will leave the toe stiff and swollen following surgery; it may also be combined with one of the other two methods, if needed. Digital anthroplasty removes half of the bone from the joint to correct the position of the toe but leaves some mobility in the joint. Digital arthodesis takes the entire joint bone while using pins and metal to support the toe during the healing process; once removed, the toe will remain permanently stiff.
Pain and discomfort varies from person-to-person, but most can expect some moderate-to-extreme swelling after surgery. You may be fitted with a post-operative shoe with a stiff wooden sole that will keep the toe from bending. Any metal pins that have been inserted during the operation will be removed in three to four weeks following the procedure. Bandages and dressing will be worn for a week and any stitches will be removed in approximately two weeks following surgery if they are non-disintegrating.
Risks & Rehabilitation
Some complications may occur after surgery such as permanent pain and stiffness in the joint or a return of the deformity to the toe. There may be persistent, permanent swelling in the toe, a corn that develops on the joint, a loose, floppy "flail" toe effect, a regrowth of the bone that was removed or a toe that does not touch the ground. Other areas of the foot may be temporarily painful, and you may eventually develop a mallet toe.
You should be able to walk on your own within four days, but crutches should be used to keep pressure off the toe. You will also need to limit walking for the first two weeks following surgery. Most patients can return to wearing wider shoes within four to six weeks, although some patients may require additional time--from three to six months--if they had surgeries with wires and pins. Swelling will begin to reduce in six to eight weeks.
You will not be able to drive a vehicle until the foot is healed enough to perform an emergency stop, usually one to two months following the operation. You may have to stay out of work anywhere from two weeks to two months, depending on your ability to stay off the foot and keep it elevated and the level or activity required in your job. Impact sports may be returned to generally within three months, although this will largely depend upon the type of surgery performed and how well it is healing.
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