Phalangeal Head Resection (Arthroplasty) for Toe Joint Deformities
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.
A bunion is an unnatural, bony hump that forms at the base of the big toe where it attaches to the foot. Often, the big toe deviates toward the other toes. When this occurs, the base of the big toe pushes outward on the first metatarsal bone -- which is the bone directly behind the big toe -- forming a bunion. If this happens on the little toe and fifth metatarsal, it's called a bunionette.
Because a bunion occurs at a joint, where the toe bends in normal walking, your entire...
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
Why It Is Done
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
How Well It Works
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:
Infection, bleeding, and pain, which can occur
after any surgery.
anesthesia, such as a change in your
blood pressure. Your specific risks depend on the type
of anesthesia used, your health, and your response to the medicines used.
Problems with blood flow in the toes, which may result in losing
some or all of the toe. How likely this is depends on how deformed and rigid
your toe is.
What To Think About
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.
American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Toe deformities. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 876–880. Rosemont, IL: American Academy of Orthopaedic Surgeons.
Primary Medical Reviewer
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical Reviewer
Gavin W.G. Chalmers, DPM - Podiatry and Podiatric Surgery
June 29, 2011
WebMD Medical Reference from Healthwise
June 29, 2011
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