Hammertoe / Toe Shortening Surgery
Hammertoes are caused by different reasons. The most common reasons are toes that are too long, or a contracted tendon. All the varieties of hammertoe problems can eventually cause pain and difficulty wearing shoes, or being active.
In the early stages, hammertoes are commonly caused by contracture of the tendons that control the toe. There are tendons on the top of the toe called extensors, and tendons on the bottom called flexors. An imbalance in the function of these tendons can cause the development of a hammertoe, a mallet toe or a claw toe. Long toes can also result in contracture of the joints and develop into hammertoes, claw toes, or mallet toes.
These can in-turn result in painful calluses, Degenerative Joint Disease (DJD, also known as arthritis), and other serious conditions like neuromas or fat pad atrophy.
Long toes are inherited and caused by genetics. Conservative solutions can include things like getting bigger shoes. This often solves the problem of contracting and callusing the toes, but it can lead to other conditions because of the lack of support a larger shoe provides.
If you are required to wear what is considered professional attire and you are female, you may suffer with calluses since most women’s shoes are not made with correct foot function or structure in their design.
The Procedure
The evo hammertoe correction & toe shortening surgery is a unique approach to surgically correcting a hammertoe or potential hammertoe problem. The procedure takes two factors into consideration:
Mechanical and functional correction of a well known podiatric problem, hammertoes.
Aesthetic approach to surgical correction of this condition.
To achieve these goals, the traditional procedure, Arthrodesis (fusion) of the Proximal Interphalangeal (the first of the 2 joints in your toes) is performed with modern method.
A side incision is used so the scar is hidden which can provide better aesthetic results. The joint will be removed and stabilized during the post operative period with an internally placed implant that will hold the bone sections together while they undergo fusion (arthrodesis). When fusion is achieved, the procedure is complete and the implant is no longer vital to the continued maintenance of the placement of the bones.
The length of the toe is adjusted based on the amount of bone removed during the fusion procedure, achieving a well aligned, proportional relationship between the lesser toes and the great toe.
The fusion of this joint will prevent motion to occur at this site, and should not limit your ability to walk, run, or bend the toes at the metatarsal joint, unless there is a complication in healing.
If you hammertoe condition is caused by tendon contracture, a tendon release or tendon transfer will be performed in an attempt to stabilize the toe and remove the deformity.
Remodeling, shaving of the bone can also be performed in both cases to further improve the deformity. The decision for the kind of procedure will be made by your surgeon based on the presenting problem with your toes.
Possible Complications Related to Hammertoe Surgery
Position/Length Variations & Creasing
In rare instances, toes can have tissue contracture which causes over or under correction of the deformity (toe sticks up or down). This can also be true when the bone at the fusion site loses density while healing and results in a toe slightly shorter than expected. Distraction or loosening of the implants can result in a slightly longer toe than originally created. Another unexpected visual result is if the toe exhibits swelling and causes creasing of the extra skin. In this instance revision surgery may be necessary to remove the creases.