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Old 04-22-2003, 03:20 PM   #1
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Post Can anyone share hammertoe surgery and recovery experiences?

It seems like a lot of users of this board have had hammertoe surgery along w/their bunionectiomy.
Can anyone comment on what/if any pain they had with their "bent" toes before surgery, what type of procedure was done (I have heard of rigid vs. floppy) and how long recovery was.
I have had a morton's neuroma removed over 3 months ago and the slightly hammered toe above it has gotten more bent and quite painful (burning, throbbing) My doctor won't address for a while due the recent first surgery.
Would love any thoughts, advice.

 
Old 04-22-2003, 06:36 PM   #2
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My understanding is that "floppy" and "rigid" are phases of a hammertoe. It's floppy at first, in that it can flatten out when you push on it or put weight on it. But eventually the bone builds up over the joint (where a callous typically forms) and then the toe becomes "rigid" and inflexible. I believe that a floppy can sometimes be corrected with surgical adjustment of tendons only, but that advanced hammertoes require work surgery to the bone and joint, and perhaps removal of bone or joint.

I had a hammertoe "done" on April 9 inconjuction with a bunionectomy. When I speak to my docotor I'll try to get more info on EXACTLy what he did. But I believe I had only a tendon release. He didn't insert any fixation.

I had problems with the toe before surgery, First, the nail was damaged. The DR said that was because the nail was hammering down into my shoe or the floor when I walked and getting irritated. I never had much pain from the corn or callous because my feet are narrow so in a comfortable old lady shoe there is always plenty of room. The second problem I had was that my foot didn't really function mechanically like it used to. For example, I didn't have the kind of control I need to tap dance. (may still not, will have to wait and see) And for anything requiring "toeing off", like running, my forefoot would just plop down instead of propelling my forward like the other foot did. That could be because of some arthritis in that foot, but there's none in the other foot, so it seems to me that the arthritis came as a result of the bunion and hammer, and that the worsening or development of arthritis could be prevented by earlier correction.

blah blah blah this foot talk is tedious isn't it

[This message has been edited by footsie (edited 04-22-2003).]

 
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Old 05-06-2003, 08:33 AM   #3
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Hey Readabook:
Think I can help, since I've had two different types of hammertoe surgeries in the last two yrs.

In March 2001, I had four of the five toes on my right foot released and fixed with pins. I actually had clawtoes that are the result of a neurological problem and followed two previous surgeries for clubfoot reconstruction in the fall of 2000. The doctor basically removed the deformed cartilage in the joints of toes 2-5, straightened the toes manually, and fixed each of them with pins. My toes looked like shish-ka-bobs! I had the pins removed four weeks later in his office and my toes felt like planks thereafter. I think the procedure was called a claw toe release (releasing a contracture), or a PIP arthroplasty (fusion of the PIP joint). Aside from getting used to the stiff toes, recovery was not that bad.

In this past surgery in Feb., I had my FDL re-released by the ankle. The FDL (flexor digitorum longus) is the major toe flexor tendon that courses from the toes, behind the ankle bone and up into the calf. I also had a flexor tenotomy done to three of the toes since they were reclawing. The recovery for this was more tedious since I have been through a year of various medical treatments and "forgot" what the recovery for foot surgery was like; with the winter, though, it was a good time to have it done! I still have calf tenderness and a great toe that pulls down. However, the toes that were nicked in the crease to release the tendon are looser than ever. No hardware for this procedure.

Never had a bunionectomy, but had tons of other tissue transfer and release work, as well as a 1st metatarsal osteotomy and heel slide done. The recovery for that took forever.

Good luck. No worries about the hammertoe -- it is very straightforward for the docs!

Cheers,
Prisc1125

 
Old 05-06-2003, 06:01 PM   #4
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Dear Prisc1125,
Thank-you for your response. I have a few more questions. When you say your toes were like planks- What is that like? You can't bend them right? Is that uncomfortable? Does it make walking/running awkward?
This may sound really stupid, but what if you bang your toes on the leg of a table- if they are fused together does something awful happen? And did you need crutches? Sorry for all of the questions, but between the achy hammertoe and now scarring from the morton neuroma surgery I am getting quite exasperated and feel the need to be as informed as possible before the next surgery!
Thank-you so much,
Readabook

 
Old 05-07-2003, 07:30 PM   #5
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I have questions, too. Please, hammertoe surgery survivors, help! My hammertoe "phlangeal head
resection" without fixation was a month ago. In an x-ray last week,(3 weeks after surgery) it appeared to me that there was a big space where my toe bones should have been connected. I'm wondering if I'll
get feeling back in the toe. I didn't expect to lose the use of it. Does the toe stay non-working forever?
Is it normal to lose the function of your toe when you have a hammertoe corrected? If so, I can't believe the doctor didn't tell me that! Can you not curl it or stretch it ever again?

 
Old 05-08-2003, 02:17 PM   #6
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Hi Readabook:
No worries about the questions. Glad my experiences could help!

Yes, the toes were like planks of wood -- stiff and unbendable. Because I cannot run anymore due to my other surgeries, I could not test it out in that respect. However, I do remember the strange sensation of having to learn to walk differently because I could not bend them as you'd expect. It is very hard to describe, but it eventually began to ease in.

As for the stubbing thing, funny you should ask. I stubbed one of my fused toes in Jan of 2002 (less than a yr out from the surgery) and near died! Since the cartilage was removed, there was less shock absorption and my toe swelled up. My ortho looked at it and suspected I broke it and took an xray. While no crack showed up, he did not totally discount the possibility.

Questions for you: What exactly is a morton's neuroma? What effects does it have? What causes it?

Good luck!

Prisc1125

 
Old 05-08-2003, 02:27 PM   #7
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Hi Footsie:
I did not see your post the first time....

I am not sure how to account for the apparent malunion of the bones. There are lots of possibilities for why the doctor approached the surgery as he did and outomes. Likewise for the nerves. Depending on the work and reason for needing the surgeries, the nerves may or may not regenerate. I don't want to scare you at all and I am a lay person to medicine, so please consider these ideas carefully. Best to check w. your doctor on this one.

What I can answer is the question about the curling, bending. No, I cannot curl or bend the toes and will not be able to again. The joint and ligament responsible for that action were removed. They are looser now, though, because the surgery in Feb. involved what is called an FDL distal tenotomy wherein the flexor tendon that controls the toes from the bottom of the foot were nicked to loosen them. The tendons began to recontract. Despite this, they are still planks and will stay as such. Hey, could be worse! At least I can walk now, which was barely the case three years ago!

Good luck!
Prisc1125

 
Old 05-08-2003, 05:21 PM   #8
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Dear Prisc1125,
A morton's neuroma is basically a "pinched nerve" that runs (usually) between the 3rd and 4th toes. It feels like there is a constant rock in there. Comes from injury, foot mechanics etc. In my case I have fairly high arches and when I started running again in my early 40's I was tending to run on my toes and really irritated the nerve. Can be treated w/ orthotics (I hate mine) cortisone injections (didn't work for me) padding, or surgery. I did surgery and was fine for awhile, but now have some complications, which I think are related to adhesions....I've worn healthy shoes since my twenties, but this happened.
So I don't know what I'll do about the hammertoe. Foot surgery takes such a long time to heal from. Have tried putting padding around the toe, but doesn't seem to help. Was your toe(s) uncomfortable before the surgery and how long were they uncomfortable after? You seem like you certainly have had a lot of experience in the "foot healing" department. Wonder how you manage?! It's crazy making.

 
Old 05-08-2003, 05:50 PM   #9
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Hi Readabook!
Thanks for this explanation. Hey, at least you had fun by running.....I know it really is a pain though. Does the doc think you'll continually have to go through this?

My hammertoes, actually clawtoes, got progressively worse. My toes started taking the shape while in a cast (apparently) and my ortho noticed them. Gave me squishy toe things to straighten them and had my husband try to straighten them daily. A month later, despite these measures, they were not cooperating and the procedures to straighten were excrutiating. Another month later, my PT and I decided they were not going anywhere and I could not walk right (gait training at this point). The toes were fixed. My ortho decided that all I could do was have them straightened surgically. The tops of the toes were getting red and shiny from friction in a shoe.

I had in the pins in for a month and walked around in an ortho shoe and crutches at the beginning. Then I just hobbled for the rest of the time. I'd also had a screw taken out of my heel from the heel slide surgery so I had all kinds of pressure points!

I am managing, with the knowledge that what I have now is much better than three years ago when I could barely walk. It's taken 4 reconstructive surgeries and I've accepted that there will always be a level of "suck up pain" as a trade-off. I am very grateful for the results; it took me three to four yrs to find my doctor with lots of misdiagnoses before. My husband has been absolutely phenomenal, esp given this happened a year after we got married.

Prisc1125


 
Old 05-08-2003, 07:41 PM   #10
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Hello Prisc1125!
Well, I never really did get a chance to enjoy running- started it later in life and then hurt myself! Should have stuck w/walking. Haven't even done much of that in two years. Will look into pilates I think.
What a brave lady you are w/all of the things you are going through. Are you working during all of this? Ever out of pain? How long does it seem to take you to recover from all of the individual surgeries? I think that is what is the hardest to understand- others seem to be getting around so much more quickly. My doctor only seems to give me information as needed, and that everyone is different etc....
Regards!

 
Old 05-09-2003, 07:19 AM   #11
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Hi Readabook,
Unfortunately, I have not been working, mainly because the June before all my surgeries started (Oct 2000), I got laid off from my job. The co. discountinued the product a bunch of us were hired to develop. I am very grateful to my husband and all he has done for me during this time. With the current economy, I've been unsuccessful finding new work.

For the first two surgeries, I was in continuous recovery mode. The third was not as much of a shock as this last one because of the time that elapsed. This time 'round, I recovered very quickly b/c I was in great shape going in. I also did pilates during the recovery. Mentally, it was much more exhausting though.

I know what you mean about the quotes doc may give for recovery. It is true that no one really knows, as has been the case for me. For this time, my doc was pretty accurate, esp with how long I'd be laid up. I pushed the ante near the end and in a week, went from an aircast, to a shoe, to driving so I could get myself to PT. Not advisable!

Hang in there!

Prisc1125

 
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