Hammer Toe Surgery Explained Podiatry Claw Toe Mallet Toe

©2009
www.DrGlass.org
glass.dpm@gmail.com

Project Lead:
Nicholas Giovinco
Contributing Authors:
Kristen Diehl
Doug Doxey

Resource Consultant:
Kelly Powers

Producer:
Nicholas Giovinco

A "Hammer-Toe" deformity, describes a pathological condition of abnormal or exaggerated contracture at the metatarsal-phalangeal and inter-phalangeal joints of the toes. This is mainly due to an imbalance between the muscular flexors and extensors as well as intrinsic interossei and lumbrical muscles within the forefoot.

A hammer toe deformity may present as one of three morphological variations. A true hammer-toe deformity will exhibit dorsiflexion at the metatarsal-phalangeal joint and plantar flexion at the proximal interphalangeal joint. Whereas a mallet toe solely results from a plantarflexory contracture of the distal interphalangeal joint. A simultaneous combination of these two conditions is thus known as a claw toe.

Clinically, a hammer toe may present with hypertrophic callosities on the plantar surface of the corresponding metatarsal head and the distal/plantar tip of the toe in addition to a painful corn over the proximal interphalangeal joint.

A radiographic analysis of a hammer-toe deformity in the Anterior/Posterior or Dorsal/Plantar view will reveal a hallowed point or gun barrel appearance of the middle phalanx.

Although conservative care may involve shoe modifications, padding, strapping, and custom orthosis; surgical reconstruction may be required to alleviate painful and immobilizing hammer-toe conditions.

This surgical management of the hammer-toe deformity is performed by variable means of "Sequential Reduction." By this, a hammer-toe contracture is alleviated through various procedures in order to re-establish a functional position during active motion as well as rest.

This process may include, a lengthening of the extensor tendons, followed by a resection of the extensor hood. An "Arthroplasty" may be utilized to increase useable joint space within the proximal inter-phalangeal joint by removing the head of the proximal phalanx.

In more extreme deformities, a tenotomy of the flexor tendon may be utilized. This may be accompanied by a fusion of the joint itself, known as an "Arthrodesis," whereby the base of the middle phalanx and the head of the proximal phalanx are combined to form one continuous bone mass.

By balancing the forces of plantarflexion and dorsiflexion at the joints of the toe, a Hammer-toe operation may result in a drastic improvement of the functional mobility of the foot and leg during gait.

2009 DrGlass.org
glass.dpm@gmail.com

Category:

Education

Tags:

• Podiatry
• Podiatric
• Mallet
• Claw
• Hammer
• Toe
• Surgery
• Callus
• Corn
• Phalanx
• Digit
• Operation
• Reconstruction
• Reconstructive
• Foot
• Feet
• Video
• Procedure
• Arthodesis
• Arthroplasty
• Tenotomy
• Extensor
• Hood
• extreme
• callus
• corn
• orthotic
• orthosis
• plantar
• dorsal
• contract
• flex
• tip
• nail
• point
• pad
• arch
• crest
• sulcus
• bunion
• valgus
• varus
• fusion
• plasty
• pain
• discomfort
• shoe
• rub
• wear
• blister
• ingrown
• nerve
• bone
• capsule
• bursitis
• head
• resection
• procedure

[carolynbryce1]

I am thinking I need this correction on both feet;the toes next to my big toe.  It seems to be someone hereditary.. if that is possible... my dad.... grandma.... sister. Extremely painful to stand and walk at times. I am a teacher so that is basically an all day task. I wear heels a lot because it actually makes it feel better but no matter what shoe I wear.. it is painful. I basically am standing on the end of of my toenail which causes pressure. Plus my toes end up cracking open and bleeding.

[DrGlassDPM]

@carolynbryce1 Foot types and structure do follow a hereditary pattern. It sounds like you've already tried a number of conservative options. No luck?

[AleCKSis1000]

aww i have to get this surgery im only a teenager too and i play sports alot ughh does it hurt at all??

[DrGlassDPM]

@AleCKSis1000 there can be some post operative discomfort.

[DannySmetana1992]

Ugh! Nooooo way am i going through that! just watching an illustrated non real video has made me feel funny lol.

[DrGlassDPM]

@DannySmetana1992 The live footage youtube vids are even more intense to view

[overclock16]

STOP. Hammer Toe!

[kewhite1968]

I have had the fusion of one toe and the tendon release of 3 toes. You are off your feet for about 14 days and in bed for about 7 days. The operation is really not that bad.

[punchybird]

I'm having my left done in a couple of weeks. I have 9 toes out of 10 that are hammer. I'm having screws in by big toe, rods in the next three and the pinkey broken and repositioned.

[Fbozboz]

TOO LONG, DIDN'T WATCH.

[rgfbg]

@overclock16 ahhhh so good!

[JesusIsTheSavior7777]

i cant even watch this without getting antsy

[t1thausand]

Performed by Homann

[carolynbryce1]

@kewhite1968 Yikes.. 14 days... all on one foot or both? i cant possibly take that much time off.