Hammer and Claw Toe Hammer toe and claw toe are painful malpositions that can occur in the area of the second to fifth toe.
If relieving therapy measures are not sufficient – which is particularly the case with fixed malpositions that cause severe discomfort – surgery is necessary. I have been performing this in a minimally invasive way for many years now, so it only requires a stab incision and not an actual skin incision. The affected joints are not destroyed by this surgical method as is usually the case, but rather preserved. After placing a special foot block with local anaesthetics and other medications as a mixture, a 12-hour pain-free period following the procedure is possible. At the patient’s request, the procedure can be performed under additional “shallow anaesthesia”. Thanks to a sophisticated pain therapy, no significant pain occurs in the follow-up phase. Hallux Valgus Hallux valgus is a chronic misalignment of the big toe. In addition to a hereditary predisposition, the splayfoot is often also responsible for the development of hallux valgus. The sunken anterior transverse arch of the splayfoot favours the widening of the ball area and thus also the oblique position of the first toe. In many cases a hallux valgus initially causes only minor discomfort, the symptoms are often purely cosmetic in nature. In further consequence, however, painful symptoms can occur, such as the development of corns, arthrosis in the metatarsophalangeal joint or nerve inflammation.
Switching to flat footwear with sufficient space for the toes – especially wearing thong sandals – can only help in the initial stages. Corrective inlays can also be prescribed, but these cannot reverse the deformity of the big toe. Once a malposition of the big toe has occurred, it can only be corrected by surgery – in case of pain, I recommend this procedure.
The surgical method depends on the severity of the hallux valgus and the existing complaints. After an analysis of the X-rays and a personal consultation, a choice is made between an open and a new revolutionary minimally invasive buttonhole technique. The use of a special foot block with local anaesthetics and other medications as a mixture allows a 12-hour pain-free period following the procedure. At the patient’s request, the procedure can be performed under additional “shallow anaesthesia”. Thanks to a sophisticated pain therapy, no significant pain occurs in the follow-up phase. After the surgery, the patient stays in hospital for a few days, whereby the length of stay is individually determined by daily rounds. Afterwards, special bandages are applied weekly in my practice. After the surgery, a special shoe must be worn for six weeks to unburden the operated forefoot. Tailor Bale of the Fifth Toe In the area of the fifth toe there may be a malposition within the scope of a splayfoot or a finding of the fifth metatarsal bone (fallat). If a shoe conflict occurs, a remedy can be found from the supply of inlays to the surgery. This procedure is also performed with minimally invasive buttonhole surgery.