Surgeons often use phalangeal head resection to correct hammer, claw, and mallet toes. In this procedure, the surgeon removes part of one of the toe bones, the phalangeal head, so that the toe can lie flat. The affected tendons are cut and then reattached to conform to the new, correct toe position. A wire or tape holds the straightened toe in place until it has healed.
A variation of this surgery, implant arthroplasty, uses an implant made of a man-made material such as silicone to replace the removed bone segment.
Most people typically have this surgery as an outpatient, so you probably will not have to spend a night away from home. But other things, such as your overall health, may make a hospital stay necessary.
The wire or tape used to hold the toe in the correct position usually remains in place for 3 to 6 weeks. Your toes may be taped together for 4 more weeks while they adjust to their new positions. You may be able to walk on the affected foot right after surgery, possibly with a special shoe. How soon you can start wearing your own shoes depends on how quickly you recover. You may need a follow-up X-ray.
If you have severe pain in a toe that interferes with your daily activities, and if nonsurgical treatments such as roomier footwear, exercises, and pain relief medicine have not helped, you and your doctor may choose to try a phalangeal head resection.
The success of surgery for hammer, claw, and mallet toes has not been widely studied. The specific results and risks vary depending on the type of surgery, your surgeon's experience, and how severe your deformity is. After surgery, most people have toes that lie flat but do not have normal flexibility.1
Possible complications of surgery include:
Hammer, claw, and mallet toes may come back after surgery. Loose ligaments in the foot, a foot with a very high arch, or a foot that rolls inward too much (excessive pronation) when you walk may cause the toe problem to return.
The affected toe or toes may remain somewhat bent after surgery.
Although surgery can reduce pain, it may not improve how your foot looks.
Last Revised: June 29, 2011
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