What is Toe Deformity Repair

Toe deformity repair is a surgery to reposition a toe that stays bent in an unnatural position. For example, a hammer toe is a deformity that causes the middle joint of a toe to stay bent.

A toe deformity can cause pain and may interfere with walking. You may need surgery if other treatments have not helped to straighten the toe and relieve your symptoms.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to nerves.
• Swelling.
• Pain.
• Numbness.
• Scarring.
• Toe positioning that is not straight (poor toe alignment).

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
  • Taking over-the-counter medicines, vitamins, herbs, and supplements.
• You may be given antibiotic medicine to help prevent an infection.

General instructions

• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be asked to shower with a germ-killing soap.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic). The medicine will be injected directly into your toe.
  • A medicine to make you fall asleep (general anesthetic).
• The surgeon will make one or more incisions on your affected toe.
• If extra bone or extra soft tissue is causing the deformity, it will be removed.
• If connective tissues such as tendons or ligaments are causing the deformity, they will be removed or relocated.
• Surgical pins or screws will be placed to hold your toe in place during the healing process.
• The incisions will be closed with stitches (sutures).
• A bandage (dressing) will be placed over the incision area.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will be given pain medicine as needed.
• You may have a post-operative shoe placed on your foot.
• Do not drive for 24 hours if you were given a sedative during your procedure.

Summary

• A toe that stays bent in an unnatural position can be repaired with surgery (toe deformity repair).
• You may need surgery if other treatments have not helped to straighten the toe and relieve your symptoms.
• Before the procedure, follow instructions from your health care provider about eating and drinking.
• During the procedure, you may be given a medicine to numb the toe area or a medicine to make you fall asleep.

Toe Deformity Repair, Care After

Here is the information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Pain in the affected area.
• Discomfort with walking.

Follow these instructions at home:

If you have a post-operative shoe:

• Wear the shoe as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the shoe if your toes tingle, become numb, or turn cold and blue.
• Keep the shoe clean and dry.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths.
• If your post-operative shoe is not waterproof, cover it with a watertight covering when you take a bath or a shower.
• Keep the bandage (dressing) dry until your health care provider says it can be removed.

Incision care

• Follow instructions from your health care provider about how to take care of your incision. Make sure you:
  • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer.
• Check your incision area every day for signs of infection. Check for:
  • Redness, swelling, or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Managing pain, stiffness, and swelling

• If directed, put ice on the affected area.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Raise (elevate) the affected foot above the level of your heart while you are sitting or lying down.

Driving

• Do not drive or use heavy machinery while taking prescription pain medicine.
• Ask your health care provider when it is safe to drive if you have a post-operative shoe on your foot.

Activity

• Walk and return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not use your affected foot to support your body weight until your health care provider says that you can. Use crutches as directed by your health care provider.
• Do exercises as told by your health care provider or physical therapist.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicine for constipation.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have redness, swelling, or pain at your incision site.
• You have fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from the incision area or the dressing.
• You have a fever.

Get help right away if:

• You develop a rash.
• You have difficulty breathing.

Summary

• After the procedure, it is common to have pain in the affected area and discomfort with walking.
• Follow instructions from your health care provider about how to take care of your incision.
• Walk and return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Keep all follow-up visits as told by your health care provider.