Phalangeal Head Resection (Arthroplasty) for Toe Joint Deformities
Phalangeal Head Resection (Arthroplasty) for Toe Joint DeformitiesSkip to the navigationSurgery OverviewSurgeons 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. Most people
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. What To Expect After SurgeryThe 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
X-ray. 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
resection. How Well It WorksThe 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.footnote 1 RisksPossible complications of surgery include: - Infection, bleeding, and pain, which can occur
after any surgery.
- Slow healing.
- Long-term (chronic) swelling of the affected
toe.
- Numbness in the affected toe.
- Limited range of motion in the affected toe.
- Risks of
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 AboutHammer, 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.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery. ReferencesCitations- 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.
CreditsByHealthwise Staff
Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine
Specialist Medical ReviewerGavin W.G. Chalmers, DPM - Podiatry and Podiatric Surgery Current as ofMarch 21, 2017 Current as of:
March 21, 2017 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. Last modified on: 8 September 2017
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