Certain deformities in your toes can cause pain, stiffness, and loss of mobility. You may have heard of these deformities being termed as claw, mallet, or hammer toes. These tend to be a result of the tendons in the toes having contracted or tightened, causing the toe to curl.
The pain is usually related to the way the affected toe rubs against your shoes or other toes. This rubbing can either be at the tip of the toe, or over the ‘knuckle’ on top of the toe. These can be very painful, and sometimes cause ulceration (breakdown) of the overlying skin.
Problems can also occur under the foot when a toe is bent upwards. This is caused by extra pressure on the ball of your foot, and sometimes results in thick, painful skin under the foot called a ‘callosity’.
Diagnosis and treatment
An initial consultation with me will involve a physical examination of your foot to confirm the presence of any of these conditions. If necessary, you may also have an x-ray to check if there are any other underlying issues that need to be addressed.
In some patients, finding a comfortable fit for your shoes is all it takes to reduce the pain. It is important to wear shoes with enough space around the toes. High heels should be avoided as these tend to place extra strain on the toes as you walk, pressing your toes into the end of your shoes. Wearing insoles in your shoes can help, and you can also buy small pads at a pharmacy to protect the painful prominences on your toes. These are known as corn pads.
If these conservative measures have been unsuccessful in bringing you relief, and your symptoms have continued to affect your daily routine, surgery to correct the deformity may be an option for you.
What does surgery involve?
The exact nature of the surgery will depend on your specific condition and how extensive any corrections need to be.
Regardless of the procedure, most of these surgeries can be performed as a day-case procedure under a general anaesthetic. Other forms of anaesthetic with you awake are also an option if you would like. The operation usually lasts under an hour.
Typically, I will make an incision over the toe deformity, and in some cases another incision at the base of the toe. Any unnecessary or abnormal bone growth can be shaved off, and I will lengthen the tendons in your toe to help straighten them and fix the deformity. The tendons are then stitched together internally, or the toe is held in place by wire. If a wire is used, it will remain prominent from the tip of your toe for six weeks before it is removed. You don’t require an anaesthetic to remove the wire.
At first, you will need to walk on crutches while your foot begins to recover, and our dedicated physiotherapists will be on hand to guide you before you leave the hospital.
During the first 2 weeks after surgery, it is very important to keep your foot elevated so as to avoid unnecessary swelling. You will be provided with a stiff-soled shoe that goes over the dressings, and you will walk with crutches.
I will see you at the clinic after 2 weeks to remove your dressings and stitches. At this stage, you can usually then begin to wear soft shoes and start to put pressure on the whole foot as you walk. If you have a wire in your toe, you will need to continue to wear the stiff-soled shoe we have provided for 6 weeks.
In terms of an overall timeframe for the toe joint to heal and all swelling to subside, recovery can take up to 6 months.
Are there any risks or complications associated with surgery?
There are some risks to be aware of with toe surgery. The main issue tends to be swelling of the toe, which can take a couple of months to settle down. There will likely be some pain and bruising after surgery that improves after a few weeks. The toe will also feel slightly numb, and again this settles down over time.
The scars can feel a bit tender and ‘lumpy’. This generally responds well to massage once the wound has completely healed, and bio-oil can be helpful for this.
Why should I book a consultation at Sulis Hospital Bath?
Our dedicated foot and ankle unit at Sulis Hospital Bath is the ideal facility for you if you have been struggling with a debilitating condition such as this.
I prefer not to use an all-encompassing treatment method; instead, I respond to your specific needs, based on the symptoms you present with, adapting treatment depending on how you respond at each stage. Alongside a dedicated physiotherapy team to guide you through your recovery and rehabilitation, this level of personalised care extends right through your time with us at Sulis Hospital Bath. Book a consultation with me today, and let me help you regain function in your foot, and work towards getting you pain free.