Understanding Interphalangeal Joint Fusion for a Hammered or Arthritic Big Toe
- Coriel
- Apr 16
- 4 min read
If you're suffering from a hammered or arthritic big toe, you may be considering surgical options to alleviate pain and deformity. One common procedure for addressing these issues is interphalangeal joint fusion (IPJ fusion). This blog aims to provide a detailed overview of what to expect from this surgery, its benefits, risks, recovery, and more.
What is Interphalangeal Joint Fusion?
Interphalangeal joint fusion involves the removal of damaged cartilage in the middle joint of the big toe (known as the interphalangeal joint) and the fusion of the bone to relieve pain, correct deformity, and improve function. The goal of this procedure is to help restore the toe’s alignment and reduce symptoms, including pain and difficulty with shoe fit.
Why is the Surgery Done?
The procedure is typically recommended for individuals experiencing:
Hammer deformity of the big toe
Arthritis in the middle joint of the big toe
Pain and discomfort from a prominent joint
Difficulty finding shoes that fit properly, even when wearing sensible footwear
In these cases, the surgery provides several benefits, including pain relief, a straighter toe, and reduced callus or corn formation.
Key Benefits of the Surgery
Pain Reduction: Fusion of the joint reduces arthritis-related pain and discomfort.
Straightening of the Toe: The procedure straightens the big toe, improving function and appearance.
Prevents Further Deformity: It helps to prevent worsening of joint deformities, such as hammertoe.
Improved Stability: The fusion provides stability to the affected toe, reducing instability when walking or standing.
What to Expect During the Surgery
The surgery typically takes 30 to 40 minutes to complete. The incision is usually placed on the top of the toe, with absorbable stitches used where possible. The joint's cartilage is removed, and the bone surfaces are carefully aligned to promote healing. Internal fixation, such as screws, plates, or wires, is used to hold the bones together during the healing process. These fixtures typically remain in place and do not need to be removed unless complications arise.
Risks and Complications
Like any surgical procedure, interphalangeal joint fusion carries risks. Specific risks associated with this surgery include:
A feeling of Stiffness: After the joint is fused, you may experience reduced mobility and stiffness in the toe.
Non-union or Delayed Union: The bones may not fuse properly or take longer to heal.
Fixation Problems: The screws or plates may become loose or fail to hold the bones in place.
Floating Toe: The toe may not touch the ground, leading to an altered gait.
Long-Term Swelling: Some swelling may persist in the toe for a long time.
Alternatives to Surgery
While surgery is often the best option for severe cases, there are other ways to manage symptoms before considering surgical intervention:
Pain Management: Medications such as painkillers or anti-inflammatories.
Footwear Adjustments: Wearing appropriate shoes or insoles.
Joint Injections: Cortisone injections or other therapies.
Protective Foot Pads: Padding in shoes to reduce pressure.
Additionally, another surgical option is arthroplasty, which involves the removal of part of the joint. Your consultant can help you explore these alternatives based on your condition.
Recovery After the Procedure
Recovery varies depending on the individual and the nature of the surgery. Here’s a general timeline of what to expect after interphalangeal joint fusion:
Immediately After Surgery
Hospital Stay: This is typically a day procedure, meaning you can usually go home the same day after a brief period of recovery.
Post-Operative Care: You will need a competent adult to help you at home for the first 24 hours. You may need to wear a cast or air cast boot to keep weight off the foot.
Pain Management: Painkillers will be provided to help manage discomfort.
1 to 2 Weeks Post-Surgery
Redressing Appointment: You’ll visit your doctor for a redressing appointment, and stitches may be removed.
Continued Rest: You will need to continue resting and may be required to wear a cast or air cast boot for further support.
2 to 8 Weeks After Surgery
Weight Bearing: Depending on your specific surgery, you may or may not be able to bear weight on your foot. If you're able to, your doctor will advise you to wear sturdy shoes or trainers.
Increased Activity: As you gradually increase your activity level, you may experience some swelling and discomfort, which is normal. Physical therapy may be recommended to aid in your recovery.
8 to 12 Weeks After Surgery
Continued Healing: Most people will see significant improvement during this period, with reduced swelling and discomfort.
Sporting Activities: Depending on your recovery, you may be able to return to light sports after 3 months.
12 Weeks and Beyond
Final Review: A follow-up appointment will occur around 6 to 8 months post-surgery to assess your final recovery and improvement.
General Risks of Foot Surgery
As with any foot surgery, there are general risks involved, such as infection, bleeding, and anaesthesia complications. These risks are outlined in the preoperative information booklet you will receive.
Interphalangeal joint fusion for a hammered or arthritic big toe is an effective solution for those suffering from chronic pain, deformity, and difficulty with foot function. While the surgery offers significant benefits, it's important to understand the procedure, potential risks, and recovery process before moving forward. Be sure to consult with your healthcare provider to determine whether this is the right option for your specific condition.
If you have any questions or concerns, do not hesitate to contact The Coriel Clinic for further information or to speak with your consultant.
