In severe cases, surgeons are testing bone grafts to restore bone length in patients who have had previous bunion surgeries or when damage from osteoarthritis has occurred.
Complications, though uncommon in even the most complex procedures, can include:
- Continued pain
- Infection
- Possible numbness
- Irritation from implants used to support the bone
- Sometimes, the metatarsal bone is excessively shortened.
Recovery from more invasive procedures, such as arthrodesis or osteotomy, may take 6 - 8 weeks before a patient can put full weight on the foot. In such cases, patient will need to wear a cast or use crutches. Elderly patients may need wheelchairs.
Hammertoes
A hammertoe is a permanent deformity of the toe joint in which the toe bends up slightly and then curls downward, resting on its tip. When forced into this position long enough, the tendons of the toe contract, and it stiffens into a hammer- or claw-like shape.
Hammertoe is most common in the second toe but may develop in any or all of the three middle toes if they are pushed forward and do not have enough room to lie flat in the shoe. The risk is increased when the toes are already crowded by the pressure of a bunion. Lying down for long periods, diabetes, and various diseases that affect the nerves and muscles put people at risk.
 | Click the icon to see an image of a hammertoe. |
Treatment for Hammertoe. At first, a hammertoe is flexible, and any pain it causes can usually be relieved by putting a toe pad, which are sold in drug stores, into the shoe. To help prevent and ease existing discomfort from hammertoes, shoes should have a deep, wide toe area. As the tendon becomes tighter and the toe stiffens, other treatments, including exercises, splints, and custom-made shoe inserts (orthotics) may help redistribute weight and ease the position of the toe.
Surgery. Surgery may be needed in some severe cases. If the toe is still flexible, only a simple procedure that releases the tendon may be involved. Such procedures sometimes only require a single stitch and a Band-Aid. If the toe has become rigid, surgery on the bone is necessary, but it can still be performed in the doctor's office. A procedure called PIP arthroplasty involves releasing the ligaments at the joint and removing a small piece of toe bone, which restores the toe to its normal position. The toe is held in this position with a pin for about 3 weeks, then the pin is removed. A 2000 study reported that after 5 years, 92% of patients who had arthroscopy were still pain free.
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