Hammertoe surgery is probably the most common surgery performed in the United States and certainly one of the most common surgeries I perform in my San Diego practice. These days, it’s become a simple outpatient surgery done under local anesthetic with sedation. Most of the time you’re able to ambulate right away and back to your normal activities fairly quickly.
When I perform hammertoe surgery at La Jolla Outpatient Surgery Center and UCSD, I utilize an absorbable dissolving pin. This pin stays entirely within the toe and eliminates any metal that is potentially used during the procedure or any pins that traditionally were used, that used to come out the end of the toe.
By utilizing this type of device, we significantly decrease post-operative pain, practically eliminate the risk of infection postoperatively and make the procedure a much simpler and user-friendly procedure for our patients. Below is a description of the typical hammertoe surgery process. I encourage you to visit my website at drberenter.com if you have any questions.
Hammertoe Surgery Procedure
A precise small incision is made over the deformity to allow for optimal scar healing and range of motion of the toe after the surgery is completed. There is minimal to no bleeding during the procedure due to the use of an ankle tourniquet and electric cautery.
The bone that is to be removed is carefully freed from overlying tendon and soft tissues attachments. The contracted soft tissues overlying the metatarsophalangeal joint are also freed so as to allow proper positioning of the toe. Further release of the joint is accomplished with the use of a McGlamry elevator to obtain maximum correction over the hammertoe deformity. The bone is then precisely cut with the use of an electric driven micro saw.
Once the bone is removed, a drill hole is placed into the bone to allow for proper placement of the absorbable pin.
Once all of the drill holes have been placed, a 2.0 mm Biomed resorbable pin is placed into the drill holes so as to allow the proper positioning of the toe and complete fixation at the proximal interphalangeal joint.
A portion of the pin is exposed so as to allow positioning of the end of the toe over the pin, thus securing the pin and toe in its proper position. The surgical site is then flushed with sterile saline to help prevent infection.
At this time, the wound is closed in layers with absorbable sutures starting with repair of the long extensor tendon.
By utilizing all absorbable sutures and fixation devices such as the pin, this greatly reduces the post-operative pain and complication rate associated with hammertoe surgery.
The final layer of closure is the skin which is accomplished with a running absorbable suture of 4.0 monochrome.
The final position of the toe is checked carefully and the foot is bandaged with the soft bandage and the patient allowed to ambulate with the use of a simple post-operative shoe.
By utilizing this dissolving pin, our patients tell us that their experience with hammertoe surgery is significantly easier and far less painful than a lot of their friends who’ve undergone similar procedures, but used the old or traditional methods utilizing metal implants and stainless steel pins.
Please visit my website or call my office if you have any questions. To view a video of the surgical procedure, click here: