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HAMMERTOE CORRECTION

A curling deformity of the toes is known as a hammer toe.  The toe can be painful where it rubs on a shoe and a corn can develop.  Initial treatment involves extra depth shoes or a silicone sleeve.  If the toe is still painful despite these measures, surgical correction is frequently performed.  Surgery requires cutting a piece of the bone and balancing the tendons so the toe is straight.  A pin is placed during surgery which is easily removed in the clinic four weeks after surgery.  While this procedure nicely corrects the deformity, the toe will no longer curl.  In addition swelling and some sensitivity are often seen for four to six months.

This surgery is generally successful, but as with any surgery there are risks.  These include infection, numbness, and bleeding.  We try hard to make your surgical experience as pleasant as possible and have found the following points helpful.

  1. We use a re-circulating cold water unit called a “polar pack.”  Mark with Pacific Medical will contact you before the surgery date and arrange for you to pick this up.  Please bring this with you to surgery as it will be applied during surgery.  The polar pack helps to reduce swelling and decrease pain.  Turn the polar pack every two hours for 15 minutes to prevent your foot from becoming too cold.
  2. Elevation helps with pain and swelling.  You need to elevate your foot above your left shoulder constantly the first 72 hours and then frequently the first 10-14 days.
  3. You will need to be on crutches the first 7-10 days following surgery and then you may weight bear as tolerated in the bunion shoe.  You will need to bring your crutches with you to surgery.  There is a list of providers attached.
  4. You will be in the bunion shoe following surgery.  You need to wear this 24 hours a days for the first four weeks or until the pins are removed.  After the pins are removed you may wean into a regular shoe as pain and swelling allows.
  5. You will have pins in your toes for the first four weeks.  You need to keep your foot dry until these are removed.  Pin removal is done in the clinic and is surprisingly painless.  If the pin starts to work its way out of your toe, do not push it back in, call the office immediately.
  6. The first night of surgery you will have some bleeding; this is normal.  We see you the following day in the office for a dressing change.  You will have another follow up appointment 10-14 days following surgery for suture removal.  You will then have an appointment four weeks following surgery for pin removal.
  7. In order to minimize pain after surgery, we generally use regional anesthesia, called a popliteal block, so that you have no pain for 6-18 hours after surgery.  During this time your foot and ankle will be numb and will not support you.  It is important that you start your pain pills before this block wears off.  We recommend you start your pain pills when you get home and then set your alarm clock the first night of surgery so that you wake up and take your pills around the clock to maintain a constant level of medication in your system.  Following the first night you may take them then as needed.  Below are a list of common used medications and their dosages.
If you have questions or concerns, please feel free to call your physicians's nurse at 323-2600.
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