Toe and Forefoot Deformities Overview
Walking or simply wearing shoes can be extremely uncomfortable when you have bunions, hammertoes, and other toe and forefoot deformities. If you’re suffering pain or irritation when wearing shoes, have limited movement of the toes, redness, swelling, irritation, a lump on the toe or foot or an abnormal bend in your toe, it’s important to see a doctor. If left untreated, bunions, hammertoes, and other forefoot conditions can become progressively worse and more difficult to treat. Open sores may develop on the toe, which can lead to infection. In some cases, surgery is needed to correct the problem.
At MedStar Health, our podiatric surgeons have extensive experience treating conditions that affect the lower extremities. The following are a few conditions they commonly treat:
- Bunions occur when the big toe moves inward or toward the other toes, forming a painful lump at the base of the big toe.
- Tailor’s bunions (also called bunionettes) may develop as a sensitive bump on the smallest, outer toe.
- Hammertoes happen when there’s an abnormal bend in the middle joint of a toe, causing the tip of the toe to bend and face downward.
- Mallet toes affect the joint nearest the toenail, most commonly the second toe.
- Claw toes affect the four smaller toes at the same time, causing the toes to curl downward.
- Brachymetatarsia (also called short toe) occurs when there is one or more abnormally short or overlapping toe, most commonly the fourth toe.
Toe and forefoot deformities may be inherited, congenital or caused by injuries to the foot (e.g., wearing tight shoes), structural abnormalities of the foot, an imbalance of muscles in the toe or foot, or health conditions such as arthritis or diabetes.
Planning and Recovery
What to Expect
During your appointment, your doctor will first examine your feet and toes for signs and symptoms of bunions, hammertoe, or other conditions. He or she may request an X-ray image of the affected foot to uncover any abnormalities in the bone structure. Your podiatric surgeon will determine which treatment options are best for you depending on your age, the severity of symptoms, conclusions drawn from an X-ray exam, and other factors.
Nonsurgical treatment: If symptoms are mild, your doctor may recommend conservative treatment options such as wearing shoes that are looser and have a wider toe box, using orthotics or custom shoe inserts to reposition the toes and relieve pressure.
Surgical treatment: If symptoms are severe and affecting your ability to walk comfortably and correctly, your doctor may recommend surgery. A bunionectomy is a surgical procedure that may involve removing the bunion, realigning the bones that make up the big toe, or balancing the muscles and tissues around the joint so the deformity does not return. Hammertoe surgery releases the bent position of the toe, reduces pain and discomfort, and increases the overall function of the toe and foot.
Recovery after Podiatric Surgery
During the first few days following surgery, it’s important to keep your swelling down and minimize your pain. You will also need to keep your foot elevated and avoid walking on it. After a few weeks, you can begin bearing more weight on the affected foot. Your doctor may give you a special shoe or boot to wear to protect your toe, as well as require that you rest your foot during this time. Physical therapy may also be recommended to help you regain your strength. Your orthopedic foot and ankle surgeon will discuss the specific details of your recovery with you before your procedure.
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Frequently Asked Questions
Yes, finding a shoe that fits properly can save your feet from painful problems later on. Wearing shoes that are too tight can cause painful ailments such as bunions, hammertoes, corns and other foot problems. Instead, choose footwear that fits well and allows ample room at the toe.
Your procedure may be covered by insurance if it is deemed medically necessary. Please contact your insurance company to determine your coverage.
Before surgery, you may be asked to get blood tests and take or adjust medications. If you smoke, quitting will help you heal faster and better avoid complications. Your surgeon may even require that you quit smoking prior to surgery. You’ll be given special instructions to follow prior to your surgery.
Recovery time depends on the type of surgery and level of correction needed, and it may take a few weeks or a number of months. Your surgeon will discuss a realistic time frame for your recovery.
Your doctor may recommend a physical therapy program to help you get the best results from your surgery. Physical therapy can help you regain range of motion, strength and flexibility after surgery.