Hammer Toe Correction
This page describes the approach to Hammer Toe Correction as taken by Mr Bowyer. Other surgeons may use variations on the technique, for instance with regard to post-operative management. It is important that you understand what your own operating surgeon intends to do, and how you will be treated after the procedure.
When footwear alterations, padding or chiropody do not help, surgery may be indicated. Surgery is usually performed as a day case, often under a short general anaesthetic.
Surgery comprises correction of the toe deformity. This might involve removing one of the toe joints (excision arthroplasty), Oxford procedure, or realigning the bones (osteotomy such as Weil’s osteotomy). Small incisions will be made over the affected joint or at the base of the toes to be corrected. Through these incisions the surgeons will correct the bones or lengthen the soft tissues of the toe, to allow it to be brought down. The bone might then be cut to allow the toe to be straightened. It might be held in it’s new position with a small screw (which usually remains in the toe for ever), or with a wire going in from the tip of the toe (which is usually simply removed in outpatient clinic about 4 weeks after the operation); sometimes no fixation is needed. The wounds will be sutured, and the toes bandaged in a special way to help maintain the new position.
Surgical Aftercare & Recovery
Following your operation you should sit with your leg elevated to help decrease the swelling. You will be able to walk around, but it is important to keep the foot up as much as possible when you are sitting and resting, particularly in the first week or so after surgery. You will be seen in clinic about 10 days after your surgery, to check the incision and lighten any dressings. You will be given advice on how to gently mobilise the toes. The toes will be a little sore, but should not be very painful. You will be given a special shoe to wear to protect the foot for approx 4 weeks, and a physiotherapist will show you how to walk using crutches. You will also be given advise with regards to weaning yourself into normal shoes, and resuming normal activity, at about 4 weeks after the surgery.
You will be seen in clinic to have your stitches removed approximately 2 weeks after your surgery. After about 4 weeks you may begin to gently mobilise the toes as instructed at your clinic appointment. You will also be given advise with regards to weaning yourself into normal shoes, and resuming normal activity.
Most cases go smoothly and about 80-90% of cases are judged by patients to have been a success. There are, however, always risks of complication when doing any surgery. In bunion surgery these include the following:
- Failure to improve the position or symptoms
- Recurrent deformity, or stiffness of the toe
- Injury to nerves (numb or hypersensitive toe)
- Bone not healing, or screws becoming prominent and requiring removal
- General surgical / anaesthetic complications such as blood clots
How do I know if I have a Complication?
- Many of the problems become obvious with time, however you should notify the hospital or a doctor if you get an increase in your pain or swelling after you go home which does not settle with rest, elevation and mild pain killers, as this may indicate an infection
- You will be seen in an outpatient clinic in the weeks following your surgery to enable your doctor to monitor your progress