How is the Surgery Performed?

Hammer toes are often stuck in a bent position that cannot be straightened without surgery. The operation to straighten them involves taking out the joint that is stuck in one position. The bones are held in a straight position with a wire that sticks out of the end of the toe. This is removed after six weeks.

If you do not wish to have a wire sticking out of the toe, then a metal device can be inserted which grips the bone from the inside, but if there is an infection around this, it must be removed and the toe may become flail. An xray of this device is shown below

The vast majority of these operations pass without any difficulty and a good result is achieved, but there are small risks of complications.

If the toe has been stuck in a bent position for a long time, then straightening it may stretch the blood vessels underneath the bone. If this occurs, the toe bone may need to be shortened to take the tension from the blood vessels. If this problem becomes apparent after surgery has finished, the wire will need to be removed from the toe to allow blood to get into the end of the toe and this toe will remain a little flail. If the problem is not recognised, the end of the toe may die from not having any blood and turn black. This is a risk of surgery.

Surgery is carried out under general anaesthetic, but can be carried out with local anaesthetic injections behind the knee or around the ankle. The injections are normally given while you are asleep for your comfort. They can give good pain relief for the first day after the operation. You can go home the same day in the evening.

Risks of Surgery

Bleeding, infection, poor bone healing, poor skin healing, injury to tendons, injury to nerves, recurrence, and a need for further surgery.

There is a small risk of blood clots in the legs or lungs (DVT and PE), and there are also risks from anaesthesia - the process of being put to sleep for your operation.

Risks of Anaesthesia

The injection behind your knee is given using an ultrasound machine to guide the needle. There is a less than 1% chance of injury to the nerve. General anaesthetic also carries risks. These risks are proportional to your general health. You will need to be assessed for your fitness for surgery and an Anaesthetist will be able to advise you on your individual risk.

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