Toe deformities and toe instability can be both uncomfortable and painful. Symptoms oftentimes present in the ball of the foot, which can be mistaken for a neuroma. Assuming you get a correct diagnosis, wearing shoes with extra depth and inserts can prove helpful.
In the event that non-operative methods fail to provide relief, surgical correction will involve reconstructing and balancing the ligaments by tendon transfer or release. In some deformities, cutting the bones is necessary. The surgery is performed on an outpatient basis, and it’s one of many procedures that Dr. Silverman has a performed successfully countless times in the past.
Are you suffering from a hammertoe or other deformity on one of your smaller toes?
If so, let Dr. Silverman help.
For more information about surgery for hammertoes and toe deformities, keep reading.
What Happens Before Toe Deformity Surgery?
The surgical center will provide you with individualized advice in the days and weeks leading up to your operation. On the day of your surgery, the anesthesiologist will give you a regional anesthesia known as a Popliteal nerve block. You will be given medication to induce “twilight sleep”, placed on your stomach, and a small needle will be used to inject Novocain-like medication around the nerve in the back of your leg. It gives complete pain relief that lasts for 12 to 36 hours after surgery. Patients report extraordinary satisfaction with this type of anesthesia.
What Happens During Toe Deformity Surgery?
During the surgery you will be put into a relaxed state by the medication delivered through the I.V. A tourniquet will be placed around your calf, and you will not feel the pressure because of the nerve block. Incisions will be made along the top of your toe and your foot. Occasionally, an incision is required on the bottom of the toe to transfer a tendon. If needed, the toe bones are cut and secured with screws or pins after the ligaments are rebalanced. X-Rays taken during the surgery confirm the correction. At the conclusion of the procedure, the wounds are closed and dressed.
What Happens After Toe Deformity Surgery?
You will be permitted to leave the surgical center once your anesthesiologist is satisfied that you have recovered. During this recovery time your family member may take your prescription to the nearest pharmacy. You will be given crutches. Take your narcotic pain control medications before falling asleep or as you feel the “numbing” effect wearing off. Remember, post operative pain is much easier to control with prevention. Call to schedule your first post-operative appointment for 2-5 days after surgery when you feel able.
Toe Deformity and Instability General Recovery Timeline
This timeline is a general guideline. Your post-operative course may vary.
| Elevation | 23 hours / day for 10 days; swelling may last over 4 months. |
| Motion | Move your ankle when the block resolves to decrease pain and swelling, and improve healing. Follow specific instructions for toe motion to decrease stiffness. |
| Walking | Heel weight bearing as tolerated in the fracture brace or post-op sandal. You may wean once healing is confirmed on X-Ray. |
| Bathing | Keep dressing dry. You may shower but do not bathe. |
| Dressing | After three days begin twice daily dressing changes. Gently tighten the Ace wrap each time for better swelling control. After 4 weeks (pins removed) use Pedifix Forefoot Compression Sleeve. |
| Pain Control | Expect to use strong narcotics for the first 3-5 days. Wean off as soon as you are comfortable using Tylenol or Ultram (Rx only). |
| Work | Return depends on specific demands. It is safe to return to sedentary work at 10 days post-op. Return to heavy labor will take at least 3 months. |
| Driving | Patients with left foot surgery may drive an automatic transmission. Patients with right foot surgery must wait until healing is adequate and they feel safe. |
| Routine Clinic Visits | |
| 2-5 days | Dressing change and X-Ray. |
| 4 weeks | X-Ray and Pin removal |
| 6 weeks | X-Ray, Earliest time of bone healing to permit time out of boot or shoe. The time to return for your next visit varies significantly. |
| 3-4 months | Return for recheck; Strength improves over then next year. Minimal feelings of discomfort may linger, your overall comfort level improves over a year. |
If at any time during your post-operative period you notice any drainage or foul odor from your incision, a temperature of more than 100.4 degrees and/or increased swelling or tenderness, you should contact our office. For more helpful tips, check out these rehab exercise videos that will help you recover, or reach out to Dr. Silverman for more information!