Foot Surgery: Claw/Hammer/Curly Toes – OPCS

Although many folk have problems with the above conditions, not everyone requires surgery.

Surgery is usually required when there is painful redness over the tips of the toes or over the tops of the knuckles rubbing against shoes and when alternative footwear has been provided and is not acceptable.

Surgery to straighten toes involves a minor ten minute operation where the lips of skin and joint is removed from the top surface of the toe and the toe straightened and held still with a stainless steel cocktail stick called a k-wire. This would be left in a thick bandage and you will be sent home the same day. You should elevate your foot for a couple of day, keep the area dry and I would usually see you in two weeks to remove stitches and at six weeks to remove the wire in the Outpatients setting.

Wire removal is usually far less unpleasant than most people anticipate and then afterwards one can get back into routine activity. The toe will often stay quite swollen for several months afterwards, but the pain should improve once the toe has been straightened.

Bunion (Hallux Valgus) – OPCS W7900

Bunion’s are extremely common and are either the result of a genetically broad foot, and/or inappropriate footwear. They can also occur later in life as a result of dropped arches, rheumatoid arthritis etc.

Overwhelmingly if it is appearance of the foot rather than pain, one would do our best to avoid surgery, as surgery can give the patient a straight foot, but may cause some degree of pain due to the change of alignment of the foot, which can in a small number of cases cause pains elsewhere in the foot.

I will need to examine both your feet and may also need to organize an X-ray. If your bunions are severe and/or fail to improve with spacers, splints and broad toe boxed shoes and if you can accept a 10% chance of dissatisfaction and further pains in the future, surgery will be performed usually as a day case.

This would involve a cut over the top of the foot and either the soft tissues around the toe will be released in order to straighten it, or the bone will be broken and re-set to align the toe.

This would usually allow you to go home the same day, but occasionally you may be kept in over night if you are uncomfortable. There will be a thick bandage on the foot and possibly wires coming out of the foot and therefore the foot will need to be kept elevated and dry for several days afterwards. I would review you in Outpatients in three weeks to remove sutures, check upon the wound, and usually any wires and further dressing would be removed at the six week period.

If the bone has been broken (an osteotomy) one would not be allowed to take full weight upon the front of the foot for six weeks or stand on tip toe or run for three months. I would usually leave you in a ski boot orthosis afterwards for some six weeks. If just the soft tissues have been released one could walk earlier. I usually recommend that you do not drive for a month after the osteotomy.

It may take six months or so for the swelling to go down and as previously stated 10% of folk have some concerns over the residual position of the foot and/or some residual pains.

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