28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)

Name of the Procedure:

Correction, Hammertoe (e.g., Interphalangeal Fusion, Partial or Total Phalangectomy)

Summary

In layman's terms, the correction of a hammertoe involves surgically straightening the toe. This can be achieved through techniques like fusing the small joints within the toe (interphalangeal fusion) or removing part or all of the bone in the toe (phalangectomy).

Purpose

The procedure addresses hammertoe, a deformity causing a toe to bend downward at the middle joint, resembling a hammer. The primary goals are to relieve pain, correct the deformity, and restore normal toe function.

Indications

• Persistent toe pain that interferes with daily activities.
• Difficulty walking or wearing shoes.
• Corns, calluses, or other skin irritations due to the toe deformity.
• Failed conservative treatments such as orthotics, physical therapy, or medication.

Preparation

• Follow your doctor's instructions, possibly including fasting for a certain period before the surgery.
• Adjustments to current medications, especially blood thinners.
• Preoperative diagnostic tests like X-rays to assess the toe's structure.

Procedure Description

1. Anesthesia: Local, regional, or general anesthesia is administered to ensure the patient is comfortable and pain-free.
2. Incision: A small incision is made over the affected toe.
3. Interphalangeal Fusion:
   • The bones in the joint are carefully aligned and fused together, often using pins or screws to hold them in place.
4. Phalangectomy:
   • Partial or total removal of the bone (phalanx) from the affected toe.
5. Closing: The incision is closed with sutures, and a bandage is applied.

Duration

The procedure typically takes 45 minutes to an hour, depending on the complexity.

Setting

The surgery is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

• Orthopedic surgeon or podiatrist.
• Surgical nurse or technician.
• Anesthesiologist or nurse anesthetist.

Risks and Complications

• Common: Infection, bleeding, swelling, and pain.
• Rare: Nerve damage, blood clots, recurrence of deformity, and prolonged healing time.

Benefits

• Relief from pain and discomfort.
• Improved ability to wear shoes and walk comfortably.
• Restoration of normal toe alignment and function. Benefits are often realized within a few weeks to several months post-surgery.

Recovery

• Follow post-operative care instructions, including keeping the foot elevated and applying ice.
• Use of crutches or special footwear may be necessary initially.
• Physical therapy exercises might be recommended to regain strength and flexibility.
• Generally, recovery can take 6 to 8 weeks, with follow-up appointments to monitor progress.

Alternatives

• Conservative treatments like orthotic devices, padded shoe inserts, and physical therapy.
• Medication for pain relief.
• Pros of non-surgical alternatives include lower risk and no recovery time; cons are that they might not effectively correct severe deformities.

Patient Experience

During the procedure, the patient will either be lightly sedated or completely asleep, ensuring no pain is felt. Post-surgery, the patient may experience pain and swelling, which can be managed with prescribed pain medication. Elevation and ice application help reduce discomfort and swelling.