Bunion and Hammer Toe Surgery: Everything You Need to Know
At our clinic, we offer bunion and hammertoe surgery using advanced techniques that relieve pain and correct foot deformities. In this brief summary, you will find key information on how this procedure is performed, the most innovative surgical methods available and what to expect during the recovery period.
In our clinic, we employ advanced and minimally invasive surgical methods that minimize recovery time and improve aesthetic results. Each patient receives a detailed evaluation by our podiatric experts to define the most appropriate surgical approach, thus ensuring the highest quality and personalized treatment.
What are claw and/or hammertoes?
Claw and hammertoes are common types of foot deformities that affect the toe joints. These conditions usually develop when there is an imbalance in the muscles, ligaments and tendons that normally hold the toes in place. In claw toe, there is an abnormal curvature at the joints that causes the toe to bend downward, starting with a rise at the base of the toe and ending with a curvature at the joints closest to the tip.
Hammertoe, on the other hand, is characterized by a bending at the middle joint, giving the toe a curved shape similar to a hammer. Both deformities can be the result of continuous pressure on the feet, neurological problems, or anatomical alterations such as bunions, which deviate the big toe towards the second toe, increasing pressure and causing these deformities. Knowledge of these conditions is crucial for effective treatment and to prevent progression of stiffness and pain.
Bunion and hammer toe surgery
At Clinica San Roman, we understand that claw and hammertoe deformities can be a progressively worsening problem, but may initially go unnoticed. Here we explain in a simple and professional way what you need to know:
Claw and hammertoes: These deformities may start out mild and flexible, meaning that the toes can still fit into shoes without causing pain. However, over time, they can become stiff and painful, especially in the forefoot (metatarsalgia).
Stages of deformities:
Flexible:
Toes show visible deformity but can stretch and return to their normal position on foot support or manual pressure.
Semirigid:
Toes show a deformity that is not fully corrected by pressure or by resting the foot.
Stiff:
At this advanced stage, the toes are permanently deformed and pain becomes noticeable with the use of regular footwear.
Diagnosis and treatment: A specialist will be able to assess the degree of deformity by means of a detailed physical examination. Mild cases may require only shoe modifications or non-invasive treatments, while advanced and rigid deformities often require surgical correction.
I
he importance of treating bunions:
It is crucial to address any bunions early, as they can contribute significantly to these toe deformities, leading to more complex and painful treatments if not managed early.
Why do claw and/or hammertoes occur?
At Clínica San Román, we use minimally invasive techniques to treat these conditions, always seeking the well-being and effective recovery of our patients.
Claw and hammertoes arise due to muscle and tendon imbalances caused by anatomical or neurological factors. Over time, these deformities may worsen due to various causes:
Bunions:
These can cause instability and deformities in the big toe, eventually affecting the other toes.
Inappropriate footwear:
Shoes with high heels and narrow toes can compress the toes, contributing to these deformities.
Trauma and injury:
Previous injuries or surgeries to the feet can lead to toe deformities.
Genetics:
Hereditary alterations in the muscle structure of the fingers may also predispose to these deformities.
Risk factors:
Age:
Risk increases with age.
Gender:
Women are more likely to develop these conditions.
Foot configuration:
A second toe longer than the first (Greek foot) increases risk.
Medical conditions:
Inflammatory diseases and diabetes may favor the appearance of these deformities.
What is the relationship between bunions and claw and/or hammertoes?
Bunions, medically known as hallux valgus, are visible deformities at the base of the big toe and can be diagnosed with the naked eye by the protrusion they generate. This deviation of the big toe can not only cause subluxation but also puts continuous pressure on the second toe, leading to muscle imbalances resulting in claw and/or hammertoes.
The most effective treatment for claw toes is preventive. Therefore, it is crucial to treat bunions early to avoid further complications in other toes. If a patient already has bunions or claw and/or hammertoe deformities, it is important to consult a specialist. In the initial stages, the use of customized orthopedic insoles and silicone orthoses may be sufficient. In more advanced cases, minimally invasive surgery may be considered to correct these deformities.
It is vital to visit a specialist doctor or podiatrist for a proper assessment and to opt for the best solution before the problem progresses.
Bunion surgery to prevent claw and/or hammertoes
Bunions, which vary in severity from mild to severe, can cause deformities in the adjacent toes, especially the second toe, transforming them into claw or hammer toes. In advanced cases, it is crucial to consider surgery for bunions and hammertoes and prevent future deformities.
Minimally invasive or percutaneous surgery is an effective technique to treat bunions definitively, helping to avoid the development of complications such as claw and/or hammertoes. Depending on the degree of bunion deformity, there are different minimally invasive surgical techniques that can be applied to achieve the desired correction.
This surgical approach not only seeks to relieve pain and correct toe deviation, but also to improve the functionality and aesthetics of the foot, ensuring a faster and less painful recovery compared to traditional methods.
Surgery for mild bunions or hallux valgus without fracture (no osteotomy)
Minimally invasive or percutaneous surgery for mild bunions or hallux valgus offers an effective solution without the need for bone fracture (osteotomy). This procedure, which is performed under local anesthesia, eliminates the bony deformity of the bunion and facilitates rapid recovery. Patients may experience minimal discomfort and resume normal mobility in approximately one week. Importantly, this technique must be performed by highly qualified specialists in foot surgery and with the appropriate equipment to ensure the best results.
Moderate-severe bunionette or hallux valgus surgery with fracture (with osteotomy)
For moderate to severe cases of bunions, where there is a noticeable deviation of the big toe, which may extend to the second toe, surgery includes resection of the bony protrusion and correction of the angles of the foot. If there are additional deformities, such as claw or hammertoes, these are also corrected during the same surgical procedure.
These interventions can be performed with minimally invasive techniques, avoiding the use of screws or pins, and allowing a faster recovery. The typical postoperative period lasts about 40 days, and patients can walk from day one wearing a special post-surgical shoe.
It is essential that patients consult with a podiatric specialist for a thorough examination of the foot, including a physical evaluation, digital radiographs, a computerized tread study and a vascular ultrasound of the lower limbs. The specialist will explain in detail the surgical options available, taking into account the severity of the deformity, the patient’s age and other medical conditions, so that the patient can make an informed decision about the procedure.
Corrective surgery for claw and/or hammer toes
Surgery to correct claw and/or hammertoes varies according to the degree of deformity, using techniques ranging from minimally invasive to open, as required by each specific case. The main techniques include:
Arthroplasty:
This technique involves removing part of the bone causing the deformity, which allows some mobility to be maintained and results in a shortening of the finger.
Arthrodesis:
Consists of correcting the deviation of the toe by fixing the joint in a neutral position.
Digital plastic surgery or “Cinderella feet”:
Occasionally, it may be necessary to shorten some toes by a few millimeters to achieve a proper proportion of the foot to better accommodate footwear.
These procedures can be combined with other techniques to improve toe alignment and alleviate problems such as metatarsalgia, which is common in patients with these deformities. It is crucial to consult a podiatric specialist for a complete evaluation to customize treatment to the patient’s specific needs.
Postoperative period after surgery for bunions and claw and/or hammer toes.
Recovery after minimally invasive or percutaneous surgery for bunions and claw and/or hammertoes varies depending on the specific procedure. When an osteotomy is performed, recovery time is approximately 40 days; however, for non-fracture procedures, recovery may take 7 to 14 days.
During this period, patients can walk using a special shoe, experiencing minimal discomfort and swelling, which facilitates a faster and more comfortable recovery compared to more invasive techniques.
It is essential that patients receive detailed instructions on postoperative care to ensure optimal recovery. If you have bunions or toe deformities, it is advisable to consult a podiatric specialist for an evaluation and, if necessary, consider corrective surgery using minimally invasive techniques.
Remember that taking care of your feet is vital, as they are the support base of your body throughout life.
When is it possible to walk after bunion surgery?
After percutaneous bunion surgery, it is possible to walk from the first day, although it is generally recommended to do so with the help of a special orthopedic shoe and, in some very severe cases, crutches. This type of surgery allows a faster and less painful recovery compared to more invasive techniques.
Normally, the use of special orthopedic footwear is recommended for three to six weeks postoperatively, depending on the medical evaluation and the specific type of surgery performed. This shoe helps protect the foot while it recovers and facilitates a more comfortable walk during the initial period.
It is important to remember that each patient has a unique rate of recovery, and the process may vary depending on several factors such as the severity of the deformity treated, the surgical technique used and the individual response to the procedure.
How long does it take to recover from bunion surgery?
The duration of the healing process after surgery to correct a hammertoe or bunion can vary depending on several factors such as the surgical technique used, the severity of the deformity and the patient’s individual response to treatment. Here is a summary of what is generally expected for each condition:
Hammer Finger
Initial Recovery:
Generally, a period of immobilization is required that may last from 2 to 6 weeks, depending on the type of surgery performed.
Full Recovery:
Full recovery, where the patient can resume most of their normal activities, is usually approximately one month, although this time may be extended depending on how the healing evolves and the necessary rehabilitation.
Bunion
Assisted Walking:
Patients usually begin walking the same day as surgery using a special orthopedic shoe, and this support may be necessary for 3 to 6 weeks.- Full Recovery: Complete recovery after bunion surgery using minimally invasive techniques, such as percutaneous surgery, usually requires 6 to 8 weeks. During this time, it is common to experience symptoms such as pain and swelling.
It is crucial to follow the physician’s recommendations and actively participate in the rehabilitation process to optimize healing and reduce the risk of complications. Each patient is unique, and therefore, recovery time may vary from person to person.
What associated symptoms can arise if you have bunions?
Bunions, or hallux valgus, can be associated with various symptoms and complications, not only in the big toe area, but also in the overall function of the foot. Some of the most common symptoms include:
Pain and Tenderness:
The bony bump that forms at the base of the big toe can be painful on its own, especially when wearing shoes that rub or press on the area.
Swelling and redness:
Around the big toe joint, it is common to experience swelling and redness due to irritation and constant pressure.
Difficulty walking:
Bunions can make walking painful and difficult, affecting quality of life and limiting physical activity.- Calluses and blisters: Calluses or blisters often form on the big toe and second toe due to rubbing and pressure from footwear. This can exacerbate pain and discomfort.
Gait disturbances:
Due to the pain and altered structure of the foot, there may be changes in gait, which in turn may affect other parts of the body such as the ankles, knees, hips and back.
Toe deformities:
Bunions can cause or aggravate other toe deformities, such as hammertoes, where the toes bend abnormally.
Reduced Mobility:
The big toe joint may become stiff and less mobile, making movement and flexibility of the toe difficult.
These symptoms can vary in severity from person to person, and not everyone with bunions experiences all of these problems. Effective management of bunions often requires a combination of shoe changes, orthopedic modifications and, in some cases, surgical intervention.
How is hammertoe operated?
Percutaneous surgery to correct hammertoe is a minimally invasive procedure that focuses on correcting the toe deformity and relieving the associated pain. Depending on whether the finger is flexible or rigid, different surgical techniques can be used:
- For flexible fingers: Procedures such as tendon and ligament release or lengthening, and even tendon transfer can be performed. This allows the tendon to be repositioned so that it does not pull the joint into a bent position.
- For stiff fingers: In cases where the finger cannot be straightened manually, it may be necessary to remove part of the bone to achieve correction. Once the bone is removed, the finger can be stabilized by using pins, screws or by fusing the joints to ensure that the finger remains in a straight position.
The procedure is performed through small incisions (approximately 3 mm) and, in many cases, does not require the use of permanent hardware such as screws or pins, which helps minimize complications related to these materials. After surgery, walking is possible almost immediately using a special postoperative shoe, and total recovery time varies but is generally rapid, allowing patients to resume normal activities within a few weeks.
This technique, although highly technical and requiring well-trained surgeons, offers significant benefits such as less postoperative pain, shorter recovery time, and reduced scarring and swelling compared to more invasive methods.
Bibliography
- Clínica San Román (2024) ‘What is the operation for bunions and claw and/or hammer toes’. Available at: https://clinicasanroman.com/en-que-consiste-la-operacion-de-juanetes-y-dedos-en-garra-y-o-martillo/ (Accessed: 23 April 2024).
- Johns Hopkins Medicine (n.d.) ‘Bunion Surgery’. Available at: https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/bunion-surgery (Accessed: 23 April 2024).
- Orthobullets (2024) ‘Hallux Valgus’. Available at: https://www.orthobullets.com/foot-and-ankle/7008/hallux-valgus (Accessed: 23 April 2024).
- TeachMeSurgery (2020) ‘Hallux Valgus. Available at: https://teachmesurgery.com/lower-limb/foot/hallux-valgus/ (Accessed: 23 April 2024).
- University of Washington Orthopaedics and Sports Medicine (n.d.) ‘Hallux Valgus – Bunions’. Available at: https://orthop.washington.edu/patient-care/articles/foot/hallux-valgus-bunions.html (Accessed: 23 April 2024).
- Bauer, T., Biau, D., Lortat-Jacob, A. and Hardy, P., 2010. Percutaneous hallux valgus correction using the Reverdin-Isham osteotomy. Orthopaedics & Traumatology: Surgery & Research, 96(4), pp.407-416.
- Bauer, T., de Lavigne, C., Biau, D., de Prado, M., Isham, S. and Laffenêtre, O., 2009. Percutaneous hallux valgus surgery: a prospective multicenter study of 189 cases. Orthopedic Clinics of North America, 40(4), pp.505-514.
- Brogan, K., Lindisfarne, E., Akehurst, H., Farook, U., Shrier, W., and Palmer, S., 2016. Minimally Invasive and Open Distal Chevron Osteotomy for Mild to Moderate Hallux Valgus. Foot & Ankle International, 37(11), pp.1197-1204.
