Hammer Toes and Claw Toes

Hammer toes and Claw toes are toes that are bent into an odd position. They may look unusual, have calluses or may hurt:
- A hammer toe bends down toward the floor at the middle toe joint.
- This causes the middle toe joint to rise up. It usually affects the second toe.
- Hammer toes often occur with bunions.
- A Claw toe often affects the four smaller toes at the same time.
- The toes bend up at the joint where the toes and the foot meet.
- They bend down at the middle joints and at the joints nearest the tip of the toes.
- This causes the toes to curl down toward the floor.
Surgical Procedures:

MICA:
A minimally invasive technique that uses a burr to perform multiple small bone osteotomies to correct the overall deformity of the toe

PIP Fusion:
An open technique to reduce a lesser toe deformity using a retained implant.
Hammer Toe/Claw Toe Surgery
Post Operative Instructions
Cast:
- You will have a dressing on your foot for 2 weeks following surgery
- A post op shoe will be worn for 6 weeks post op
- Any exposed wires are covered by CLEAR tape
- At 6 weeks, you will wean off the shoe and begin walking in a regular shoe
Wound:
- The surgical incision has been closed with sutures
- Do not get the cast or wound wet for the first two weeks.
- When showering place a bag over the cast and secure with tape to your leg to avoid the cast and wound getting wet
- Stitches will be removed at your 2 week appointment
- After the stitches are removed, you may begin to shower after 2-3 days
- Do not immerse the foot in water (bath, hot tub, pool) for 6 weeks
- Do not apply any lotions or creams on the wound for 6 weeks
Weight Bearing:
- You will be weight bearing as tolerated for the first 6 weeks while in a post op shoe.
- You will use a mobility device to offload your foot (crutches, walker, stirrup cast)
Medications:
- Pain medication should be used regularly for the first 24-48 hours, when required for the first 1 to 2 weeks, followed by Regular Tylenol
Driving:
- For right foot surgery you are not permitted to drive until you have completely weaned off the post op shoe
- For left foot surgery, please contact your insurance company to see if you are permitted to drive
- Driving is not permitted while on narcotics
Work:
- Two weeks off work is recommended for initial recovery
- If you are able to get to work safely, and will be seated for the majority of the day, you may return to work a couple days after surgery. This is assuming you are not taking narcotic pain mediation.
- From 2-6 weeks sedentary duties is recommended
- By 6 weeks you can gradually return to full duties
- If your job is physically demanding, return to full duties is usually possible around 8-12 weeks post operatively
Follow Up:
- You will have your first appointment 2 weeks after surgery in the Fracture Clinic
- Your next appointments will be at 6 weeks, 3 months then 6 months post operatively
- You will have x-rays taken at these appointments
Recovery:
- It is normal to experience mild to moderate pain, numbness, or tingling for the first 2 weeks following surgery
- Please come to the emergency department if you are suffering from severe pain
- You will get back to most of your activities by 6-12 months
- Swelling often remains for 6-12 months
- Residual stiffness is a normal consequence of ankle fracture
Physiotherapy:
- Six weeks after surgery you will be referred for physiotherapy (Physiotherapy protocol)