Name of the Procedure:

Osteotomy, shortening, angular or rotational correction; other phalanges, any toe

Summary

An osteotomy in the toe is a surgical procedure that involves cutting and reshaping the bones of the toe to correct deformities. This can include shortening, changing the angle, or rotating the bones of the phalanges (the small bones in the toes).

Purpose

This procedure is performed to correct deformities in the toes that may cause pain, difficulty in walking, or other functional problems. The goal is to realign the bones to improve toe function and alleviate discomfort.

Indications

• Pain and discomfort in the toe(s) while walking or standing
• Visible deformities such as hammertoes, mallet toes, or claw toes
• Difficulty fitting into or wearing shoes
• Toe overlap or crowding
• Chronic toe pain that has not responded to conservative treatment methods

Preparation

• The patient may need to fast for a few hours before surgery, depending on the type of anesthesia used.
• Medication adjustments may be necessary, including stopping certain blood thinners or other medications as directed by the physician.
• Preoperative imaging like X-rays might be necessary to plan the surgery.

Procedure Description

1. Anesthesia: The procedure can be performed under regional or general anesthesia.
2. Incision: A small incision is made on or near the affected toe.
3. Bone Cutting: Using specialized surgical tools, the surgeon cuts and reshapes the bone to correct the deformity.
4. Realignment: The bones are then realigned to the desired position.
5. Fixation: Temporary pins, screws, or other devices may be used to secure the bones in place while they heal.
6. Closure: The incision is closed with stitches.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity of the correction required.

Setting

The surgery is generally performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon or podiatric surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection at the incision site
• Bleeding and blood clot formation
• Nerve damage leading to numbness or tingling
• Nonunion or delayed healing of the bone
• Recurrence of the toe deformity

Benefits

• Relief from pain and discomfort
• Improved toe alignment and function
• Enhanced ability to walk and wear shoes comfortably
• Prevention of further deformity progression

Recovery

• Pain management with prescribed medications
• Rest and limited activity for several weeks
• Keeping the foot elevated to reduce swelling
• Possible use of a special shoe or boot to protect the toe
• Physical therapy may be recommended
• Full recovery and return to normal activities typically take several weeks to months

Alternatives

• Orthotic devices like custom insoles
• Physical therapy and stretching exercises
• Non-surgical treatments like splinting or padding
• Medications to manage pain and inflammation
• Pros: Non-invasive, lower risk
• Cons: May not be effective for severe deformities

Patient Experience

During the procedure, patients will be under anesthesia, so they will not feel any pain. After the surgery, patients may experience pain and swelling, which can be managed with medication and proper care. Postoperative instructions will include guidance on wound care, activity restrictions, and follow-up appointments to ensure proper healing.