Q Will hammertoe surgery make my toes worse?
Nothing in life is guaranteed and therefore nothing in surgery can be guaranteed either! That being said, there have been a lot of advances in surgery (especially in the area of hammertoes) which make surgery on hammertoes more predictable than years past. A common scenario is when a patient has painful hammertoes that they want to feel better, but when conservative treatments fail to provide enough relief, they are scared to go under the knife. Some people have a relative or friend who had surgery and had swelling long after surgery or now has a still crooked toe with pain still present, thought it may be in another area. Some people have toes after their hammertoe surgery which stick up in the air.
One hammertoe procedure involves fusing the joint that has been contracted for a long time. In order for a bone to fuse, a pin is often used to hold the toe straight while the bone heals. If the pin is left in permanently or beyond a certain period of time, the toe can become very stiff. A toe that is elevated above other toes after surgery can be caused from excessive scar tissue or if the tissues were not released thoroughly in surgery. This is not always avoidable, but if the early signs are caught, physical therapy and other techniques can reduce problems later.
Swelling in toes after surgery is incredibly common and normal to an extent. Your surgeon should prepare you for the swelling you will experience after toe surgery and give you realistic expectations of how long your toe can be expected to look "fat." As we get older, our ability to drain excess fluid from the toes and feet isn't as efficient. At any age, causes for long time swelling in toes includes; gravity pulls fluid into the feet when standing and walking, toes do not have lymphatics to pull fluid away from the toes, and the toes are the farthest part of the body from the hearts, so the veins have to work harder to get fluid out of the toes. In some instances a toe that had surgery may not be rid of ALL swelling until 6 months after surgery! Being mindful of your post-operative instructions and resting after surgery greatly reduces your chances of having prolonged swelling in the toes after surgery.
If your toes aren't painful enough to feel that the risks of surgery is worth while, conservative treatment options can be continued indefinitely. Don't be shy to ask your doctor to address the concerns you have about surgery and never go through surgery because you feel you are being forced to!