What is Phalangeal Head Resection?

Phalangeal head resection or arthroplasty is a type of surgical procedure in which the surgeon removes part of the toe bone.

Effects of Phalangeal Head Resection

Phalangeal head resection is often performed to correct hammer, claw and mallet toes.

Candidates for Phalangeal Head Resection

This procedure is recommended for those who have severe pain in the toe that it interferes with daily activities, and when non-surgical treatments such as roomier footwear or pain relief medicine have not helped.

Your Consultation

Prior to surgery, patients would have to undergo specific tests or examinations to obtain a successful surgical outcome. The doctor will review your medical history and medical conditions. Specific diseases, illnesses, allergies and current medications need to be evaluated by the doctor.

The Phalangeal Head Resection Procedure

During the procedure, the surgeon will remove part of one of the toe bones, the phalangeal head, so that the toe can lie flat. The affected tendons will be cut and then reattached to conform to the new, correct toe position. A wire or tape will be placed to hold the straightened toe in place until it has healed.

A variation of this surgery called implant arthroplasty uses a silicone implant to replace the removed bone segment. This is usually done as an outpatient

Recovery

The wire or tape used to hold the toe in the correct position normally remains in place for about 3 to 6 weeks. Expect that your toes may be taped together for 4 more weeks while they adjust to their new positions. It is possible that you may be able to walk on the affected foot immediately after surgery, possibly with a special shoe. You can start wearing your own shoes when you have completely recovered from surgery. You may need to get a follow-up X-ray after some time.

Risks

Infection, bleeding and pain can occur after surgery. Other possible complications are long-term (chronic) swelling of the affected toe, numbness in the affected toe, and limited range of motion in the affected toe. It is also possible to encounter problems with blood flow in the toes, which may result in losing some or the entire toe, depending on how deformed and rigid the toe is.

FAQs

What are hammer, claw and mallet toes?

Hammer, claw and mallet toes are all toe joint deformities. A hammer toe occurs when a toe (usually the second toe) bends down toward the floor at the middle toe joint. This middle joint rises up because of this. While claw toe often affects all toes (except the big toe) at the same time, causing them to bend downward at the middle joints and at the joints nearest the tip, so that the toes curl down toward the floor. The toes bend up at the joints where the toes and the foot meet. A mallet toe usually affects the second toe, but it may affect the other toes as well. The toe bends down at the joint nearest to the tip.

Should I have surgery for hammer, claw or mallet toes?

Surgery is a good option if you have hammer, claw or mallet toes. But there may be special considerations for athletes, children and people with health problems such as diabetes, rheumatoid arthritis, neuromuscular disorders, or circulatory problems.

When is surgery an option?

Patients should resort to surgery if the hammer, claw or mallet toe gets worse or if non-surgical treatment does not help with the pain or discomfort. Surgery is only performed if the symptoms do not improve with non-surgical treatment. However, surgery may not completely return the toes to their normal positions, and toe joint problems may return after the surgery. Surgery is not recommended if the toe deformity is caused by a problem with the nervous system or if the patient has a condition that affects the blood vessels.

What can I expect after surgery?

Hammer, claw and mallet toes may return after surgery. Loose ligaments in the foot or a foot that rolls inward too much (excessive pronation) when you walk may cause the toe problem to come back. After surgery, the affected toe or toes may remain somewhat bent. And although surgery can lessen pain, it may not improve the appearance of your foot.