FAQ

Frequently Asked Questions

 

1. Is this considered surgery?

A. Yes. These hammertoe, corn removal, or toe shortening procedures are surgical procedures performed under local anesthesia experienced on a similar level to dental or minor skin procedures.

2. Can you remove the corns without touching the bone?

A. Corns are caused when a joint of the toe bends out of shape in such a way that it causes the overlying skin to rub into the shoe. In most cases the joint has to be repaired at the same time the corn is removed to help assure that the corn will not form again. In some cases where it was just a bad fitting shoe that caused the corn and the joints of the toe are normal, and conservative treatments have failed, then just the removal of the corn is possible.

3. Will I have any pins or screws in my toes?

A. No. Our hammertoe correction technique utilizes a metal splint located in the bandage (not in the toe) that serves much the same purpose as an internal pin or screw. This approach eliminates the possible complications and removal issues surrounding these devices. Only in rare or unusual cases have we found it necessary to use a pin or screw.

4. Do I have to watch the procedure?

A. No. We have a vision block screen available on request.

5. Can someone be with me during the surgery?

A. Yes. There is seating for one other person of your choice in the room.

6. How long does the surgery take?

A. The procedure time ranges from 15 min to 30 min with an average time of about 20 min. Of course there is time required for x-rays and set up so expect each surgical session to be about 60 - 75 min.

7. Will I feel anything during the surgery?

A. The only area that is numbed by the local anesthetic is the toe that is being worked on. Before the start of the procedure we test the area thoroughly by pinching it and then asking the patient if they feel a pinch. If it passes that test the area is considered fully numb and you should not feel any pain or discomfort from the surgery. If you do feel a pinch we give you more local anesthetic and redo the pinch test. The rest of your foot is not numb and you may feel normal movements or light touches.

8. Are the procedures done in the Hospital?

A. No. The procedures are done in our toe surgical facility that is custom designed and constructed to optimize patient convenience, safety, and comfort.

9. Do I have to be put to sleep?

A. No. The procedures are performed under local anesthesia while you are fully awake - kind of like going to the dentist. This approach is safer as it eliminates the possible omplications of IV sedation and/or general anesthesi

10. Can I eat before the procedures?

A. Yes. We encourage eating, particularly a balanced meal, before the procedure.

11. Will the injection hurt?

A. The quick injection uses a small needle, placed in a non sensitive area and is very well tolerated by all our patients. We have found that the real problem with injections is the patient's fear of having them. For our anxious patients we have developed an effective method for helping to alleviate their tension.

12. Will the toe be sore after the novacaine wears off?

A. At this point the pain is typically absent or minor and easily controlled with ibuprofen. More rarely a patient may need a short dosing of Vicodin for comfort.

13. Do I have to elevate and ice the area after the surgery?

A. No. This toe surgery system does not require elevation and/or icing after the procedure.

14. When will the novacaine wear off after a procedure?

A. The local anesthetic wears off on average at about 6 hours after the surgery but it can vary from patient to patient from 1 hour to 24 hours.

15. What kind of pain killers do you use?

A. Ibuprofen 600 milligram tablets are generally sufficient to control most occasions of post op pain. Many patients do not require any pain meds at all. We do prescribe Vicodin to handle the more rare occasions of more severe pain.

16. Can I get my feet wet and if not, how do I shower?

A. The bandages do need to be kept dry. We supply you with convenient shower bags so you can shower normally and as often as you like.

17. Do I have to wear those "wooden" or "blue" surgical shoes?

A. No. Our cold weather shoe is a regular looking shoe with a soft toe compartment and normal sole. It is very warm in winter and is acceptable for wearing at most job environments. Our summer shoe is currently a popular Crocs style, but many other patient selectable open toed shoes may be acceptable.

18. Will I have a real big bandage on after the procedure?

A. No. Our bandages are typically less than 1 millimeter thick, applied just to the toe itself, and has a natural skin color. This type of bandage system has the advantages of allowing the use of more normal shoes (as opposed to the "wooden" or "blue" shoe) which allows for better patient ambulation and comfort during the post op period.

19. Can I have all my toes done all at one time?

A. In our opinion and experience doing "one toe at a time" (typically 2 toes per week) has many positive aspects as compared to the common practice of do "everything on one foot at one time". Major patient benefits such as no loss of work, no need for hospital, less pain and swelling, and less overall operative and post operative complications can be directly attributed to this "one toe at a time" approach.

20. Can I drive during this process?

A. Driving is permitted at all times throughout the process. Our patients have never reported a problem. Of course some companies may have restrictions on their commercial drivers.

21. Can I work out during this process?

A. Yes, with the exception of a few exercises such as the treadmill, calf raises, and leg presses. Permitted exercises are the elliptical machine, stationary bike, rowing machine, and all the rest of the weight training exercises. Other exercises can be discussed on an individual basis.

22. How long do I have to be off of work?

A. By far most patients do not miss a day of work. However some occupations may for instance require shoe gear that is incompatible with the healing toes. In cases like these some time off may be required with the length of time to be determined on an individual basis.

23. Can I go to work while I am having my toes worked on?

A. Yes. You are ambulatory after each procedure, so normal walking and getting to, from and around the workplace is common and has some positive healing effects. Exceptions to this could be if your job requires an unusual extraordinary demand on the toes (for example a professional athlete).

24. During the process can I polish my nails?

A. Fresh polish on the nails is OK and can be of help as it is generally easier to disinfect than an unpolished nail surface. Of course old nail polish that is flaking should be removed before any procedure.

25. How do you shorten the toes?

A. The shortening is done at a toe joint. The joint is like a ball and socket. The ball part is removed and then the joint is placed back together. Over the next several weeks the toe shortens to shrink the space down where the section of bone was removed. The body then rebuilds the joint that can allow movement again.

26. When will my toes start to shorten?

A. Usually some shortening is noticeable right after the procedure. The rest of the shortening occurs naturally and starts at around the third week.

27. Do the stitches dissolve or do you have to remove them?

A. We remove the stitches as soon as they are no longer needed. In our experience dissolving stitches have a higher incidence of skin reaction which can be a factor in keloid formation.

28. Does it hurt when you remove the stitches?

A. Generally the removal is painless. To accomplish this we first clean the area with soap and water to clean and soften the skin around the stitches. Next we apply a antiseptic lubricant so each stitch will slip out without catching on the skin. Finally we use macro sized suture removal instruments along with a magnifying loupe so that each suture can be cut and pulled with minimal contact with the skin.

29. Do I change my own bandages at home?

A. Most of the time no. The "bandages" we use are custom constructed precision splints, professionally glued on to the skin, then integrated with various materials such as metal bars, silicone gel sheets, and layers of supportive thin tapes. In some cases we can supply the patient with the necessary materials and training for home application.

30. What are keloids?

A. Basically keloids are an abnormal response of the body to an injury resulting in a scar that is wider, thicker, harder, and darker as compared to a scar that normally would be thin with similar thickness, flexibiltiy and color as the surrounding skin. It probably has a genetic component and is by far most prevalent in the African American race.

31. How do you prevent keloids from forming?

A. We have a 10 step Keloid Prevention Technology that we have developed and tested on thousands of toes keloid prone patients undergoing toe surgery. Every phase of the process(ie- preop, operative or post operative) has antikeloid technology built into it For more detailed information please see our practice brochure.

32. How long will it take for the scars to go away?

A. Technically speaking scars never "go away". That said, a lot can be done to reduce, hide, blend, flatten, and soften the scar in process so that the resulting scar is practically indistinguishable from the surrounding skin. The time period varies widely from patient to patient but it is generally in the range of 8-26 weeks. This is a central theme in our practice since we specialize in toe surgery on the keloid prone patient.

33. When will the swelling go down?

A. There is generally some minor swelling which is associated with the joint rebuilding which peaks at about 4 weeks post surgery. At eight weeks the toe is usually still slightly swollen but functional in shoes. From there on the swelling steadily regresses to normal. The above example is a conservative estimate as swelling can vary from patient to patient depending on several factors such as weight, circulatory status, and one’s particular propensity to swelling.

34. How long will I have some discomfort in my toes?

A. Typically the post operative discomfort is gone after a couple of days. As the toe heals over the next few weeks the discomfort is very tolerable. As you first start to get into your regular shoes (around 4-8 weeks) there may be a short period of some discomfort as the toes are compressed a bit in the shoes.

35. When will the color come back to the toes?

A. Areas of relative lightness and/or darkness compared to normal surrounding skin can occur a few weeks after the surgery. The condition is generally temporary and responds well to our topical shea butter formulations. If a pigmentation problem persists, we then can use prescription creams. Generally speaking, a patient with darker overall skin tone will be more prone to these conditions as compared to a lighter overall skin tone.

36. How long is it before the toes are healed?

A. As a rule of thumb figure on about 8 weeks. At this time most patients are in their shoes and doing everything they were doing before the procedures. Slight degrees of individual swelling sensitivity may extend the time.

37. Can I bend my toes afterwards?

A. There are usually three joints in each toe to provide movement. Typically only one joint per toe needs repair with the other two not affected movement wise. The repaired joint does get rebuilt in the healing process and can provide movement again.

Long term results obtained out of the feedback from our patients seems to indicate that the overall toe movement is quite satisfactory and not really an issue.

38. Will the corns return in time?

A. No, with the exception of a very limited number of cases involving the little toe. The little toe has over half of its surface area exposed to possible shoe friction while being the most compressed toe in the shoe. Of those very limited cases the new corn usually forms over a different part of the toe than was actually worked on.

39. Will the surgery affect my walk afterwards?

A. In our experience patients typically walk and perform all their normal activities such as dancing, bowling, and other exercise without any negative effects from the surgery.

40. Will I get arthritis in my toes later on?

A. Not in our experience. The toes when repaired generally function better in shoes and walking and thus are most resistant to forming arthritis then they were before.

41. Afterwards, will the toes look like I had surgery?

A. Generally no. Our two main goals are function and cosmesis. Our plastic surgical style incisions are calculated and designed to limit tracking, prevent keloiding, and to ultimately blend into the skin and skin lines. Our custom procedures are also carefully applied to produce a toe that fits well in the overall toe pattern and to have a natural pleasing appearance.

42. When can I get a pedicure?

A. When you are out of the bandages you can get a pedicure. Of course we may have some precautions that may apply which we would inform you of on a case by case basis.

43. I have to take care of small children, will I be able to?

A. These procedures were designed to be ambulatory with the busy patient in mind. Many of our patients have small children and have reported no problems in taking care of them.

44. What kind of shoes can I wear during the process?

A. Any shoe is usually OK to wear during the process as long as it does not press on the toes that are healing. We supply a cold weather shoe (a very comfortable closed in walking shoe style) or summer shoe (Crocs style shoe designed for medical use) for which we have experience and confidence in, that will protect the toes while encouraging good normal ambulation.

45. When can I wear regular shoes?

A. It really depends on how many toes were done, which toes were done, and what type of shoes are regular for you. For example the little toes take the most time post op to get into regular shoes because of the way the shoe impacts that toe. Obviously spike heels may take a little longer to get into than pumps. Typically an average patient case of four repaired toes takes about 8 weeks for the patient to get into most of their shoes comfortably.

46. Will my shoe size change after the process?

A. No. The toes should fit better in the shoes you already have. An exception to this would be more rare case of extremely long toes undergoing extreme shortening requiring a smaller shoe size.

47. Can I wear heels when the process is all done?

A. If you could wear heels before the process then typically you should be able to wear the same heels more comfortably after, as the fit is better.

48. Do you have other offices?

A. At the present we just have the Oak Park location, but we do have future plans for additional offices around the area.

49. How late can I make an appointment?

A. Our last surgical appointment starts at 6:30 PM. This is to accommodate our patients who wish to come to our office after work.

50. Is this process coverable by insurance?

A. Most PPO’s provide coverage for these procedures. HMO's generally do not cover them. Our insurance coverage specialists can help provide you with the coverage details of your particular policy.

Office Location & Hours

1023 Madison Street
Oak Park, IL 60302
708-771-4300

Monday 8:30 am – 7:30 pm
Tuesday 8:30 am – 7:30 pm
Wednesday    8:30 am – 7:30 pm
Thursday 8:30 am – 6:00 pm
Friday 8:30 am – 6:00 pm
Saturday Closed
Sunday Closed

 

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1023 Madison Street, Oak Park, IL 60302
708-771-4300

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