Hammertoe Surgery & Correction

hammertoe correction before and after surgery

 

Hammertoe Surgery & Correction

To know about hammertoes you really need a true comparison on what a “normal” toe is. So to start with please review the article: What are Normal toes and what purpose do they serve?

 

What kind of Professional treatments are available for your Hammertoe?

 

If you are not satisfied with your self treatments it may be worthwhile to seek out professional treatments. Of course to do that it would certainly help to know what kinds of hammertoe treatments commonly exist and what to expect from each of them. To help you, I have specifically written an article on that: see: Understanding The World Of Hammertoe Treatments.

 

Now that you know something about what kind of professional hammertoe treatments that are out there you may be ready to find a Professional who has experience in hammertoe treatments. To help you to find that specialist I have written a special guide to help you with your search: see: How to find the right specialist to treat your hammertoe, corn, or long toe?

 

I specialize in toe surgery for correction of Hammertoes, corns, and long toes so the rest of this article will be dedicated to that.

 

Goals of hammertoe surgery

 

If you were to do a search on the Internet for “Goals of hammertoe surgery” chances are that if you researched the first few pages of websites you would find that all the stated goals of hammertoes surgery would fall into one of the five categories below.

 

Common goals of toe surgery (summary of 99% of sampled informational website survey) failure of conservative treatment:

 

  • pain relief
  • prevent toe problem from getting worse
  • improve toe function
  • make toe straight
  • neutralize soft tissue forces contributing to the deformity

 

In my opinion the above goals make sense but seem a bit too general (cut and dry) and lacking in any personal connection with other important wishes and needs of the patient.

 

That is why we have an developed the technology to offer and extra set of 6 patient oriented goals for our patients considering hammertoe surgery:

 

1. A cosmetically appealing result

2. Minimizing down time

3. Minimizing potential negative and unnecessary side effects and complications

4. Enhancing the ability to wear more shoe styles with confidence such as high heels and sandals

5. Allowing the patient to continue without interruption healthy activities such as exercise routines

6. Allowing patient input into presurgical planning—for example like showing options on toe shortening positions and then showing them how that proposed shortened position looks relative to the surrounding toes.

 

These goals are achievable and can make a world of difference in your experience and satisfaction with us and your restored toe.

 

In closing this section I would like to make a note on the idea of vanity and toe surgery. I have had many patients say that they have had received professional opinions on their hammertoe and were told that they would be “vain” if the main reason for correcting the toe was to improve the appearance of the toe.

 

I completely disagree with that assessment. I have treated literally thousands of patients whose appearance of the toe(s) embarrassed them so much that they would not show their toe in public and sometimes not even to their significant other. Is it really being “vain” when you are seeking a surgical correction that includes the goal of a pleasing and naturally looking result on an unsightly toe that is significantly ruining your life?

 

Our hammertoe correction system

 

Who do we treat

 

Our typical patient is active, healthy, have busy lives, value their time, want their toes looking good and behaving in their heels and all the rest of their shoe collection and would like to show their toes publicly in sandals and open toed shoes at social events such as dinner parties, vacations, beaches and privately with their family and significant others.

 

What do we treat

 

All our patients have some combination of bent deformed toes (hammertoes), long toes, short toes, and toes with corn pigmentation formations on them. We treat with the idea of restoring beauty and function to your toes making your life better.

 

Where do we treat

 

All our treatments are done in a dedicated toe surgical facility specifically designed by Dr.Keyes from the ground up to give you the most effective, convenient and satisfying toe surgery service possible.

 

How do we treat

 

We treat your toe. Dr. Keyes has personally designed and written the code for a comprehensive toe examination computer database program that allows us to scientifically analyze exam findings over thousands of patient exams. Our system is fashioned to get your custom toe transformation treatment plan started quickly and get you back to wearing your shoe collection ASAP. All on a walk in walk out ambulatory basis while eliminating or minimizing the risks, complaints and complications normally associated with toe surgery.

 

When do we treat

 

To best serve our busy patients we have morning, afternoon, and late evening hours available for toe correction. Most patients come to the facility before or after work, spend about 1 hour or less with us for their treatment and then drive away to dinner, home, work, or shopping.

 

Why do we treat

 

For over 35 years and logging countless hours of research and practical experience, I have developed and honed my toe surgery system —Why—because of the tremendous feeling of gratitude I receive from my patients when they put their transformed beautiful toes into action.

 

In summary what you get with us is:

 

  • A board certified surgeon specializing 100% in toe surgery (Dr.Keyes), 35 years in private practice, who designed and built from the ground up a completely new toe surgery system, an innovative computerized toe exam program, and a dedicated toe surgery facility that has produced over 20,000 successful toe surgical procedures over the last 16 years.
  • An experience of a walk in walk out toe correction lasting about 15-20 minutes at a convenient time after or before work, with no pins/screws, all while you are talking and working on your laptop or phone having a granola bar and spring water.
  • Walk out of the office in either your shoes, our crocs, or our soft topped warm winter shoes to your car and drive yourself to work, home, store, or even the gym.
  • Experience the next several weeks of toe healing while enjoying your busy life with no down time
  • To enjoy your high heels and show your toes anywhere with confidence

 

Comprehensive information on hammertoes including self-diagnosing and treatment options.

 

What Is the True Definition of Hammertoe?

 

There is a relatively poor consensus in the professional world on the definition of a hammertoe1 —and it cousins the claw toe, and mallet toe. So if you search out the term hammertoe on the web you will surely discover different descriptive versions often conflicting with each other. In my opinion these variations in definitions unnecessarily cause more confusion than clarity.

 

A normal toe usually has 3 (sometimes 2) toe bones in it which are attached to each other and a metatarsal by ligaments to form 3 joints that directly affect the toe position and appearance.

 

So to help you I am presenting to you with a practical definition of hammertoe:

 

Definiton: Hammertoe:

A toe that visually displays any combination of abnormal “bending” of one or more of its toe joints in any direction irregardless of whether one is weight bearing or resting.

 

That is it—a visual inspection is all that is necessary for diagnosis of hammertoe. Now a hammertoe usually forms in three different progressive phases or stages which can only be determined by physically manipulating each toe joint to evaluate the joint motions.

 

Flexible hammertoe

 

Wherein one or more of the toe joints are abnormally bent in some way but can be straightened out manually by taking your fingers to do so. For example some people with relatively high arches coupled with very flexible joints can have straight appearing toes when standing on their feet, but when they lift that foot off the ground the toes go into a bent position. This is the early phase of hammertoe formation.

 

Semi-flexible hammertoe

 

Wherein one or more of the toe joints moves but cannot be fully straightened out manually. This is the intermediate phase of hammertoe formation that can follow when flexible toes are abnormally bent long enough that the joints adapt into that bent position.

 

Rigid hammertoe

 

Wherein one or more of the toe joints has no motion at all under manual manipulation. This is considered the end stage or phase of hammertoe formation.

 

Footnote 1 J Am Podiatr Med Assoc. 2009 May-Jun;99(3):194-7.Definitions of hammer toe and claw toe: an evaluation of the literature.Schrier JC1, Verheyen CC, Louwerens JW.)

 

What are the Causes of Hammertoes?

 

To build and finely customize the most effective treatment of HT for you— nailing down the real causes and their relative share of the deforming process is crucial. In my experience all Hammertoes have their root causes in one or more of the following four factors: (two intrinsic to the body and two extrinsic to the body)

 

1) Intrinsic (naturally belonging) to the body

a. Disease

b. Body Structure anomaly

 

2) Extrinsic (originating outside) to the body

a. Trauma (non shoe)

b. Shoe related injury

 

Underlying Disease

 

A past and present medical history is the first thing I review with you to rule out toe deforming/complicating diseases such as diabetes, obesity, rheumatoid arthritis, polio, stroke, ect. These diseases can have a profound and direct effects on the success of your treatment plan. For example if you have a neurological condition, your toes could develop into severe hammertoes due to the resulting muscle strength imbalances. Your treatment has to take into account the present and future influences of those imbalances in forming an effective treatment plan for you. Fortunately most people are fairly healthy so this category of cause is the least common that I see.

 

Body Structure anomalies

 

Next an observation based exam of general body structure, position, and gait is done which can reveal things like unnatural limping or leaning, body weight distribution, toes too long/short, high arch feet, flat feet, overlapping toes, bunions (which then affect the lesser toes). The biomechanical forces that can arise from interactions between your body structure and day to day repetitive movements are the second most common causes I discover in my patients with hammertoes. The anomalies here are genetic based meaning you did not have much choice in having them-eg- high arches. On the other hand, acquired toe deformities such as job or hobby (e.g. running) induced wear and tear on joints traced are also included here.

 

Trauma (non shoe associated)

 

This would include any accidental injury and/or past toe/foot/leg surgeries that could ultimately affect proper toe functioning. An example of this would be a direct force- eg kicking your toe into a door edge fracturing a toe and the toe healing in a bent fashion. Another example would be a car accident that caused nerve damage in the leg which caused a muscle strength imbalance in the toes. Another example is past toe surgery implant (pin) breakage. These are the third most common causes of hammertoes that I see which on the positive side tends to be easy to spot and understand their effects but on the negative side tends to be more difficult in customizing a satisfying treatment plan.

 

Shoe related injury

 

The common necessity of wearing shoes for hours on end every day is by far the largest common causative factor in the formation of hammertoes in the patients I see. A shoe forcing a long 2nd toe to get jammed up in a bent position by its standard toe box curve, a sole that tends for you to develop painful callouses which you then have to scrunch your toes when walking toe relieve the pain, or a narrow foot that fits so sloppy in a shoe that the little (5th) toe slams into the side of the shoe causing a corn.

 

In my experience what I have found in my practice is that:

• 95% of the hammertoes were found to be caused primarily from a Shoe related injury combined with some related Body Structure anomaly.

• 5% of the hammertoes were Trauma (non shoe) and/or Underlying disease cause related.

 

What are the Symptoms of Hammertoes?

 

Firstly look to see if you have the “Prime” symptom of a hammertoe. Use our "Do you have a hammertoe?" flowchart to identify if you have hammertoes.

 

keyes for toes hammertoe flowchart

 

If so, then you know you are dealing with a hammertoe and you may have one or more of the following 6 accompanying sub-symptoms.

 

Pain

 

Includes local tenderness, discomfort, all the time or occasional, on the toe itself or on the ball of the foot, usually worse when wearing certain or all shoes with relief of pain with removal of shoes. Your ability to get around, or stand for normal periods of time may also be impaired to some degree.

 

Swelling

 

Of toe, usually accompanies pain in the toe with both occurring in same location.

 

Visual skin changes

 

Plantar callous (ball of the foot), redness, corns, sores, hyperpigmentation (darker areas of skin), hypopigmentation (loss of pigment) on top/ side of a toe joint or end of toe, or nail damage.

 

Shoes don’t fit

 

Difficulty finding shoes that the toes feel good in. Usually patient remember a time when the toe(s) did fit fine in shoes but has been getting worse over a period of time.

 

Less ability to move the toe

 

Toe used to flex and move better that now. “does not act right”

 

Unacceptable appearance of toe

 

To some degree embarrassing, ruining or inhibiting your lifestyle e.g.—won’t show your feet in public and/or to people in your personal life. * Note that all the above sub-symptoms can occur on toes that are not hammertoes.

 

At this point you understand that the Prime Symptom and sub-symptoms above directly relate to some impairment of normal toe functions. (see—What are Normal toes and what purpose do they serve?—the five functions of your toes-)

 

What Can I do to Treat my Hammertoe?

 

 

Be sure your problem is really a hammertoe.

 

See Hammertoe Flowchart above to know if you really have one.

 

Be sure it is a good idea to treat this problem yourself

 

If you have for example diabetes, poor circulation, anemia, vein/artery disease, neurologic disease, musculoskeletal disease, poor vision, or can’t reach feet, then professional help is usually wise.

 

List out your symptoms

 

If you are having symptoms such as moderate to severe pain, redness, swelling then it is quite possible that the toe is infected and professional help should be sought after.

 

What are you really treating

 

Corns, bent toe,difficulty in fitting toe in shoe, unsightly appearance, nail damage, patches of too much or too little pigment, toe appears too long/short next to other toes, soft corns between the toes, underlapping/ overlapping toes? The remedy will usually be specific to which one(s) of the above you have.

 

95% of the time the cause of the hammertoe is your toe not fitting in the shoe right.

 

Isolating out which of your shoes might be responsible for your toe problem and getting rid of them is probably the most effective self treatment as it directly addresses the shoe related unjury cause (see that section) and the shoes don’t fit symptom.

 

Seek temporary relief

 

Treatments such as over the counter pads can give temporary relief of pain on “bent” part of the hammertoe impacting the shoe.

 

Other common treatments such as hammertoe correctors, insoles, arch supports, exercises, stretches, taping toes together, foot soaks may help short term but generally are not satisfying long term.

 

For a more in depth info article on patient self treatments see: Hammertoe-What Can I do?--Q&A with Dr.Keyes.

 

 

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

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