Joint Fusion (Arthrodesis) of a Toe Joint

You and your doctor may choose to use joint fusion surgery for hammer, claw, or mallet toes. You may make this choice if:

• You have another toe problem, such as a bunion, with your toe joint problem.
• Your toe joint deformity is caused by a disease of the nerves or muscles (neuromuscular disease).
• A previous toe joint deformity comes back after an earlier surgery.

Description

In joint fusion, the surgeon removes part of the toe joint, letting the toe bones grow together (fuse). Your surgeon will:

• Give you a type of anesthesia.
• Make a cut over the top of the abnormal joint and remove part of the toe joint.
• Straighten the toe so the bones will fuse together.
• Possibly put a wire or other device through the joint to keep the toe straight. The wire will stick out of your toe, so that it can be removed without another surgery.
• Close the cut with stitches.

In about 10 to 14 days, your surgeon will take out the stitches, and in 4 to 6 weeks, he or she will take out the wire. During this time, be sure to follow your doctor's instructions for caring for your toe.

The procedure may vary depending on which toe is abnormal and how severe the abnormality is. Always talk to your doctor and surgeon about what will happen during your procedure.

What to expect

You will be able to move around by walking on your heel. Avoid putting weight on your toe, as the bones need time to fuse together. Your toe will strengthen over the next few months. Talk to your doctor about how active you can be during this period of time and when you will be able to return to work or school.

You may have to wear a special type of shoe or a walking cast during your recovery.

After the surgery, you will not be able to bend the toe joint, and your toe may not touch the ground. Most people think this is better than the pain and disability caused by the toe joint problem. But it may cause slight instability or imbalance when you walk.

How well it works

The success of surgery for hammer, claw, or 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.

If you want surgery to improve the way your foot looks, not necessarily to relieve pain, you may be less satisfied with the outcome.

Complications

Your bones may not fuse together. If this happens, you may need another operation.

The wound or wire site may become infected. If this happens, you will probably need antibiotics, and your surgeon may remove the wire earlier than normal.

Swelling may last for a long time.

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