Hammer, claw, and mallet toe deformities can lead to pain, discomfort, and difficulty with footwear. IP joint arthrodesis (fusion) with an implant offers an effective surgical solution to correct these deformities, reduce pain, and improve toe alignment. Here is everything you need to know about this procedure and the recovery process.
What is IP Joint Arthrodesis (Fusion) with Implant?
IP joint arthrodesis involves the fusion of the interphalangeal (IP) joint in the toe to straighten and stabilise it. The surgery includes removing a small piece of bone from the joint and inserting an appropriately sized implant, such as a Toe Grip or Smart Toe implant, to facilitate bone fusion. This implant is generally left in place unless it causes irritation.
The procedure is relatively quick, typically lasting 15 to 30 minutes, and does not require a cast.
Why Consider This Surgery?
The main aims of IP joint arthrodesis are:
To reduce pain caused by toe deformities.
To straighten the toe and improve alignment.
To minimise callous or corn formation caused by the deformity.
Advantages:
Reduces instability and malalignment, addressing the root cause of the deformity.
Risks and Considerations
As with any surgical procedure, there are specific risks to consider, including:
Recurrence of the deformity.
Floating toe (toe may not touch the ground) in 10% of cases.
Increased prominence of adjacent toes.
Weakness or lack of toe purchase.
Infection (3%).
Prolonged swelling.
Revision surgery required in 2% of cases.
Your consultant will discuss these risks with you and explain how they are managed to ensure the best possible outcome.
Who is a Candidate for This Procedure?
This surgery is typically recommended for individuals with:
Painful hammer, claw, or mallet toe deformities.
Prominent or painful toe joints.
Difficulty finding comfortable footwear despite sensible shoe choices.
Alternative Treatments:
Adjusting activity levels.
Painkillers and anti-inflammatory medications.
Changing footwear styles or using toe protectors.
Regular podiatry care to manage symptoms.
What to Expect During Surgery
The procedure is performed under a local anaesthetic, ensuring you remain awake but pain-free. Sedation or general anaesthesia may also be an option if preferred. You will spend time in the day surgery unit both before and after the procedure for monitoring.
A responsible adult must accompany you home and assist you for the first 24 hours after surgery.
Recovery Timeline
First 2-4 Days:
Pain is typically most intense during this period, but prescribed painkillers will help manage it.
Rest is essential. Keep your foot elevated and minimise movement.
Use crutches as instructed to avoid putting weight on the operated foot.
One Week After Surgery:
Attend a follow-up appointment for dressing changes and progress checks.
Gradually increase activity within pain limits. Pain or swelling indicates overexertion.
Two Weeks After Surgery:
Sutures will be removed if necessary.
Bandages and crutches are no longer required, and you can get your foot wet.
Begin wearing trainer-style shoes.
2-6 Weeks After Surgery:
Any pins used will be removed during this period.
The foot begins to feel more normal, though some swelling may persist.
Return to regular shoes is possible for most patients (4-6 weeks).
Driving can resume if you can safely perform an emergency stop. Confirm this with your insurer.
Manual labour may require additional recovery time.
6-8 Weeks After Surgery:
The foot continues to improve, with reduced swelling and discomfort.
Sporting activities may be considered after three months, depending on recovery progress.
Six Months After Surgery:
A final review will assess your long-term recovery.
Swelling should be minimal, and the benefits of the surgery will be evident.
Twelve Months After Surgery:
Full healing is achieved, and any remaining improvements will stabilise.
Planning for Recovery
To ensure a smooth recovery:
Arrange for assistance with daily tasks during the initial weeks post-surgery.
Follow all care instructions provided by your surgical team.
Attend all scheduled follow-up appointments to monitor healing progress.
IP joint arthrodesis with an implant is an effective solution for correcting hammer, claw, or mallet toe deformities and improving foot function. By adhering to recovery guidelines and maintaining follow-up care, most patients experience significant improvements in mobility and quality of life. If you are considering this procedure, consult your healthcare provider to determine if it is the right option for you.