The disease involves flexural contracture of a toe in the interphalangeal joint and the metatarsophalangeal joint, with frequent dislocation of the toe. The deformity often concerns several toes. The most frequent ailments include pain in the interphalangeal joint contracture area, including development of a skin callus caused by footwear pressure. The surgery consists in cutting out of the contracted interphalangeal joint and reduction of the metatarsophalangeal joint.
The hammer toe surgery is performed in the hypoemic area obtained by placement of a compression band over the thigh. The treatment involves cutting out and stiffening of the first interphalangeal joint as well as reduction of the metatarsophalangeal joint dislocation, which frequently requires elongation of the extensor ligament. The correction effect obtained ought to be stabilised, usually for 6 weeks, with Kirshner wire inserted through the skin. There is a possibility of stiffening the interphalangeal joint with the use of intramedullary implants. This method does not involve removal of the joint, as the whole implant is placed within the bone.
Side effects and complications
Performance of any medical intervention may involve the risk of side or adverse effects.
These may include body temperature increase after the treatment, temperature increase in the operated joint, reddening of the joint skin and of the surgical wound area, separation of the wound, which is connected with a prolonged treatment process. Hematomas (skin bruising with local tenderness) appear in the surgical wound area. Painfulness appears for several weeks after the treatment, with the strongest pain experienced for 2-3 days after the treatment and after beginning of the rehabilitation process.
The most frequent complication is swelling of the toe, which persists for several weeks and hinders rehabilitation. In terms of frequency, the second complication is swelling of the whole limb. This ailment is related to standstill in venous and lymphatic circulation, which may lead to vein inflammation and thrombosis which requires weeks’ long treatment and deteriorates rehabilitation effects. In some cases, a thick scar develops in the area where surgical cuts were performed. Pain and sensation disorders, including skin hyperesthesia, may appear in this area. A very rare complication is unplanned bone fracture or fracture of implants during the treatment. In occasional cases, vessels or nerves in the operated limb may be damaged or infection of the surgical wound may develop.
The risk of complications is several times higher in case of emaciation or obesity.
The correction effect obtained ought to be stabilised for 6 weeks.
Performance of the surgery itself does not guarantee elimination of the ailments suffered so far. The final treatment effect is closely related with observing the doctor’s recommendations and undergoing the full cycle of rehabilitation treatments, adapted to the individual needs of each Patient.
- pharmacotherapy: analgesic and anti-inflammatory medicines administered generally (pills, suppositories, intramuscular injections) or locally in the form of ointments and gels, with the possibility to strengthen the effects with physical therapy – iontophoresis and intra-articular injections;
- rehabilitation: foot and ankle joint exercises, analgesic and anti-inflammatory physical therapy;
- use of orthopaedic footwear inserts or orthopaedic shoes.