Reconstruction, angular deformity of toe, soft tissue procedures only (eg, overlapping second toe, fifth toe, curly toes)
CPT4 code
Name of the Procedure:
Reconstruction of Angular Deformity of Toe (Soft Tissue Procedures Only) Common Names: Toe Realignment Surgery, Overlapping Toe Correction, Curly Toe Surgery
Summary
This procedure involves surgical reconstruction to correct angular deformities of the toe, often involving soft tissue adjustments. It is typically used to address issues like overlapping second toes, fifth toes, or curly toes by realigning the toe to its natural position.
Purpose
The procedure aims to correct malformations and deformities of the toes, alleviate pain, and enhance functionality. It helps patients walk more comfortably and wear shoes without discomfort.
Indications
- Overlapping second toe
- Fifth toe malalignment (e.g., overlapping or underlapping)
- Curly toes causing discomfort or difficulty in walking
- Pain and difficulty with footwear due to toe deformity
- Cosmetic concerns impacting the patient’s quality of life
Preparation
- Patients may need to fast for several hours before the procedure.
- Pre-procedure assessments including blood tests and imaging studies (e.g., X-rays) might be required.
- Adjustments in routine medications, especially blood thinners, could be necessary.
- Detailed discussion about the procedure, risks, benefits, and anesthesia with the medical team.
Procedure Description
- The patient is placed under local or general anesthesia based on the specific case and patient preference.
- A small incision is made near the deformed toe.
- Soft tissue adjustments, such as tendon release or ligament repair, are performed to realign the toe.
- The toe is positioned in its natural alignment.
- Sutures are used to close the incision.
- A bandage or a surgical dressing is applied to protect the site and maintain the new toe alignment.
Duration
The procedure typically takes about 30 minutes to 1 hour, depending on the complexity of the case.
Setting
This procedure is generally performed in an outpatient clinic or a surgical center.
Personnel
- Orthopedic surgeon or podiatric surgeon
- Anesthesiologist (if general anesthesia is used)
- Surgical nurses and assistants
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma
- Nerve damage resulting in numbness or pain
- Recurrence of toe deformity
- Adverse reaction to anesthesia
Benefits
- Relief from pain and discomfort
- Improved toe alignment and functionality
- Enhanced ability to walk and wear footwear comfortably
- Positive cosmetic outcome
Recovery
- Post-procedure instructions include keeping the foot elevated and limiting activities that stress the toe.
- Pain and swelling are controlled with prescribed medications.
- Sutures may be removed in about 1-2 weeks.
- Full recovery and return to normal activities typically take 4-6 weeks.
- Follow-up appointments are necessary to monitor healing.
Alternatives
- Non-surgical treatments like taping, splinting, or using orthotic inserts.
- Physical therapy to strengthen surrounding muscles and ligaments.
- Injection therapy for pain management.
- While non-surgical options may relieve symptoms, they often do not correct the anatomical deformity as effectively as surgery.
Patient Experience
During the procedure, patients under local anesthesia might feel minimal discomfort but no significant pain. Post-operatively, mild to moderate pain and swelling are managed with medications. Patients can expect some activity restrictions and a gradual return to regular functions, with significant improvement usually noticeable within a few weeks.