2nd toe hammer toe operation and swelling

by Carol
(UK)

I'm nearly 7 weeks into post op,I have swelling of the toe and it still hurts to walk,no shoe is comfortable to walk in,even the softest leather,filled in or sandals.

My surgeon said he didn't need to see me after my pin was taken out at week 5 and I didn't need to have physio,however it has swelled after the pin was removed and has hurt too,I havnt got a hot toe but am concerned on how it hurts me to walk,it has really slowed me down and I sort of walk with a limp because of the pain,should I be experiencing this at week 7?

RESPONSE

Hi Carol,

Aside from your pain, the bigger issue here is the swelling of the second toe. Any one who performs hammertoe surgery knows that the second toe has a tendency to swell, but more importantly has a tendency to stay swollen forever.

It is seven weeks since your surgery and the swelling, along with your pain needs to be addressed.
When I perform second toe arthroplasties (hammertoe surgery), once the sutures are removed, I have my patients wrap the toe daily, first thing in the morning, with a product called one inch coban which is like an Ace bandage material.

The toe is wrapped every morning under moderate compression, to try and keep the swelling down that occurs through the course of the day.

The fact that you still have pain is not of a great concern assuming the pain is slowly diminishing. Granted part of the pain is due to the swelling, but in hammertoe surgery the bone has been remodeled and it can take a while to stop hurting.

If....your pain has not progressively diminished and you have reached a point where the toe is not getting better then you need to go back to your surgeon.
Whether your surgeon likes it or not, his or her responsibility goes beyond the actual performance of the procedure.
In most cases the following needs to be done.
1. daily application of compression dressing
2. physical therapy to help reduce swelling
3. possible cortisone injection into toe to help swelling

Having a swollen toe now is understandable, but having that toe swollen for the rest of your life will make for an unsightly appearance.

I have no idea how old you are, or how heavy you may be or any other medical information on you, so I am not able to predict the chances of toe staying swollen.
That is why I am recommending going back to your surgeon for some further guidance.

Marc Mitnick DPM
DISCLAIMER