Contraindications for claw toe surgery

Claw toe surgery can often be performed under regional anesthesia, so the risk of anesthesia is relatively low. However, a good blood supply to the toes is absolutely necessary in order to allow good healing after the operation. Therefore, claw toe surgery should not be performed in cases of arterial circulatory disorders (window dressing, peripheral arterial occlusive disease). Claw-toe surgery should also not be performed if bone growth has not yet been completed in adolescence.

Surgical procedures

The most frequently performed surgical techniques at present are

Flexor tendon deflection
Resection arthroplasty according to Hohmann
Joint preserving displacement osteotomy according to Weil

In the case of flexible hammer and claw toes, a joint-preserving tendon redirection operation can achieve a good positional correction. In this case, the direction of traction of the tendons is specifically changed to correct the position. It is not necessary to use metal for stabilization.

In the case of rigid claw or hammer toe malpositions, the head of the basic limb is removed and the shortened flexor tendon is expanded by manual correction. In rare cases, it may be necessary to loosen the capsule of the metatarsophalangeal joint on the back of the foot. If the correction is successful, the toe can be stabilized with a so-called plaster traction bandage.

If several cells have been operated on or an internal splinting is necessary to ensure the correction result, a thin Kirschner wire is inserted along the longitudinal axis of the toe. This wire can then be removed after approx. 14 days.

Claw toes can also be successfully operated using the joint-preserving displacement osteotomy according to Weil. This technique requires the removal of a piece of the metatarsal bone. In order to preserve the joint, a middle piece of bone is removed and the metatarsal head is screwed to the rest of the metatarsal bone using a screw.

To treat the existing claw toe, the muscle tendon is then stretched. Both therapy options usually achieve good results.In Germany, the Hohmann technique is mostly used in the surgical treatment of claw toes. Which therapy is appropriate in each individual case depends not only on the individual clinical picture, but also on personal tendencies and the recommendation of the treating physician. For both operations, exercises should be carried out after the operation, which can significantly improve the healing process. It is important to follow the recommendations of the attending physician in order to make the individual prognosis as favorable as possible.