BUNION & HAMMERTOE CORRECTION
Patients who have pain at the big toe where it connects to the foot (first metatarsal phalangeal joint) may have a deformity known as a bunion. This condition is progressive in nature causing it to become worse over time causing the toe to angle outward and even sometimes causing to second toe to cross over the big toe. Bunions can be caused by several issues including tight heel cords, improper shoe gear, flat feet, and even can be hereditary in nature. Deformities of this nature can lead to osteoarthritis, pain, difficulty to wear certain shoes, and can limit ability to walk or perform activities. The initial steps to treatment of these deformities is using proper fitting shoes with wide toes and avoiding heels higher than 2 inches. Several other conservative measures include RICE (Rest, Ice, Elevation, Compression}, physical therapy, corticosteroid injections, and custom shoes or orthotics.
When bunions progress past relief from conservative treatment, surgery may be indicated. Dr. Hook has many techniques for every type of bunion presentation focused on realigning the joint and its supportive soft tissue structures. The surgery will take place at the hospital or surgery center and rarely would require a hospital overnight admission. Recovery commonly takes 3-6 weeks but pain and swelling can be an issue for some patients for up to a year.
A hammertoe is a deformity of the second, third or fourth toe. In this condition, the toe is contracted at the joint in the middle of the toe, as this causes a deformity where the toe resembles a hammer. Hammer toes are often caused by a contracture of the tendon that flexes the toe, resulting in a
cocked-up deformity of the affected digit and surrounding structures that can be both cosmetically displeasing and physically painful. Typical causes of this flexor tendon contracture can be due to long metatarsals, a tight achilles tendon, injury or rupture of the capsular structures, and can be seen in certain neuromuscular diseases. These deformities are typically characterized by either a flexible or rigid deformity which determines the course of treatment by the surgeon. Conservative therapy for these deformities starts with shoes with a larger toe box, padding, taping, physical therapy, and cortisone injections. When this deformity progresses and conservative therapy does not provide relief, surgical correction may be performed. Surgery will take place at the hospital or surgery center and rarely would require a hospital overnight admission. The technique usually is based upon the flexible or rigid nature of the deformity. Postoperatively the patient will be able to walk weight bearing in a surgical shoe for 4-6 weeks until the incisions and bone have healed. Recovery commonly takes 4-6 weeks but pain and swelling can be an issue for some patients for up to a year.
For more information, please visit link for Dr. Hook’s post-operative protocol at link below: