Hammertoes/Claw Toes

[chrissytina]

I am so sad to say that I have hammertoes and am scheduled to have surgery this week.
The problem is after seeing 2 specialist there is inconsistency in advice and procedures. On each foot; 1 doctor suggested that I get 4 toes done, 1 suggested that I get 2 done, 1 suggested 1 type of surgery, the other suggested a different type. I know that my 2nd toe is bad! It leans to the side and I literally walk on the side of my nail. My middle toe is arched high with corns (which by the way, this is all very uncomfortable and like many others, I have tried everything from larger shoes, cushions, foams, etc.; also, I hate the way my feet look. I consider myself to be a pretty attractive woman, however, I am told often that this is defintely "my flaw" and teased tremendously about this.
My questions are:
What is taken into consideration when making the decisions of the "type" of surgery that is best fit for each individuals case?
What are "all" of the surgical options? What are the differences in each?
What are the differences in the outcomes; the scarring, the straightness, the corns?
Cosmetically, is there a big difference in the way the feet look ater the hammertoes have healed?
Will the toes look normal?
When the forum says that the tendons are cut and the toes can not bend; does this mean they don't bend as normal toes or at all (manually)?
How straight will the toes be, the last two (if I don't get them done are slightly- (very slighty) curled, will the other two stand out?
I really apologize for asking soooooo many questions, however, unfortunately, my last doctor was not very helpful in helping me to get a better understanding.
I suppose that I ran over our appointment and scheduled time due to the volume of appointments that he had; he obviously could not spend much time with me.
Sincerely in need of Answers ASAP,
Chrissytina

[footproddoc]

You should only consider having 2 toes operated on. The toe can be fused if really bad or a straight hammer toe procedure can be performed. The tendon if cut should be sutured back together. The tendon does not have to cut unless it is a very sever problem. The scarring is not an issue and they usually heal without a problem. The toe maybe slightly larger after the surgery.

[footdoctor]

i will attempt to answer as many of the questions that you have and as complete as possible but recognize there is no substitute for a good clinical exam and set of x-rays in hand...first of all hammertoes are either flexible or rigid...this will provide direction to all other thought processes...if pressure upward against the ball of the foot causes the toes to lay down flat then they are considered flexible...yours do not sound like they are in this category...rigid hammertoes are usually corrected with a procedure called an arthroplasty where a small portion of one half of the joint is removed to allow the toe to relax and lay straight...a part of the procedure may require tendon work but it is generally repaired as part of the procedure...a pin may be used to temporarily maintain the toe in a corrected position but it is removed post-operatively...there are joint replacements and internal fixation devices that do not function well, or have a great enough life expectancy to be considered... the function of any corrected hammertoe will be compromised to some degree, particularly with flexion activities... they should certainly be straight post-op...complications may ocurr but are generally rare...regarding the multiplicity of surgeries, as a surgical rule= if it ain't broke don't fix it is my philosophy...where pain or problems do not currently exist you risk creating the same by doing a procedure where the need is not well demonstrated...if the 4th and 5th toes are as minimally involved as you describe, then i would leave well enough alone...if they become an issue in the future you can address them at that time...hope this helps...
Dr. L

[steveberde]

I have a follow up question on the above - I too have a hammer/claw toe on the fourth toe of each foot - I get terrible blisters which in turn then turns into a caluouse and then another blister etc - it's a very painful and annoying situation which occurs whenever I walk a distance or exercise for any length of time - I am a very active 68 year old male - it seems it's gotten progressively worse in the last few years - I have been to an orthopedic (m.d) who specializes in foot and ankle issues who talked about a surgical procedure on each toe after x rays were taken -

How do I find out about a QUALIFIED podiatrist that can consult with me and why would I go to a Podiatrist over an orthopedic surgeon - My wife had a bunionectomy 20 years ago by a DPM and the result was superb however he is not in practice any longer. I must get these taken care of as I do not want to become an invalid or give up exercise.

Many thanks

Steve

[footdoctor]

I would search your area thru the american college of foot and ankle surgeons or the american board of podiatric surgery...a board certified podiatrist and one residency trained for two years would be a starting point...someone in practice for 10+ years would be a benefit as well...no offense to the young docs out there but i believe it takes a few years in practice to develop the proper attitude and relationship between the skill, logic, and compassion...there are good foot and ankle orhtopedic surgeons...i have two that are very fine friends...the general philosophy is similar but most, despite their specialized training do general orhtopedics as well and my friends would readily admit, it is a "part" of their practice, not their only focus...best of luck...
dr.L