One thing we don’t discuss very often at the toe doctor is toe surgery. We often mention it as an alternative in the treatment portions of our toe problems guide but rarely delve into the specifics. The reason for this is that we believe that many toe injuries can be healed without expensive surgery and that in many cases, toe surgery may be unnecessary and take just as much time for the toe to recover than it would using traditional treatment methods.
There is however a point that some toe injuries and problems reach when surgery is the preferred method and solution. Today we’d like to go over some of the most common operations for toe pain and at what point the surgery is required.
Hammer Toe Surgery
Even though hammer toe is almost always self inflicted, there are still times that this sort of toe problem needs to be solved through medical intervention. Since hammer toe occurs when the toe is forcibly bent and locked in an unnatural position, the surgery usually goes of one of three ways: tendon transfer, anthrodesis or arthroplasty. Tendon transfer involves correcting the afflicted tendon into it’s proper place manually by operating on the toe. Toe arthrodesis entails fusing the joint together after straighting the toe to hold it in place to prevent it from curling. Toe arthroplasty involves cutting away inflamed tissue and sometimes replacing with a man made implant.
Arthritic Toe Surgery
There are a variety of surgeries for toe arthritis, some that preserve the joint and some that destroy it. The type (preservative or destructive) will be determined by a trained expert using a series of x-ray examinations.
The toe joint preservation surgeries include Cheilectomy, Kessel-bonny and decompression osteotomy. Cheilectomy entails removing the excess bone and some of the joint surface to improve movement capability of the joint. A related operation is the Kessel-bonny which removes a small piece of bone from the base of the big toe which increases the distance you can lift your heel before the arthritic toe touches the ground (and causes pain). Decompression osteotomy involves shortening the arthritic toe joint to reduce impact area.
The toe joint destructive procedures involve either joint implants which replace the worn out or affected joints, or joint fusions. Joint fusions involve removing parts of the toe joint and fusing the remaining pieces together. The joint will remain stiff but this action can often relieve the pain of toe arthritis.
Cosmetic Toe Surgery:
We generally don’t recommend cosmetic toe surgery unless the toe is in terrible condition after a trauma. Cosmetic toe surgery for the sake of appearance can often be expensive and unnecessary. That being said if a broken toe or other toe injury has caused the foot to appear deformed or maybe a toe bunion is causing problems, some intervention may be needed. Cosmetic toe surgery varies depending on the the reason for it but often it involves returning the foot to it’s original appearance after a hammer toe operation or even the removal of toe corns.
There are many, many types of toe surgeries and we’ve just touched on a few of the more well known ones. What we’d like to reiterate is that toe operations should be a last resort. You can do a lot to prevent the formation of toe problems and stop injuries before they occur.