Claw toe and hammer toe surgery in Barcelona

What can be done without surgery?

Without surgery, what generally helps is footwear of the right size or wide footwear, avoiding high heels, shoes with soft insoles, corn pads or felt pads and splints that the podiatrist can make.¹ Pads or covers, special shoes, passive stretching and strapping of the toe are also cited.²

Gentle stretching exercises may be tried only if the toe is not yet in a fixed position. If it is treated early, surgery is often avoided.¹

The CGCOP lists as alternatives to surgery painkillers and anti-inflammatories, suitable footwear, offloading insoles, silicone sleeves or similar devices and periodic removal of hyperkeratoses. They may improve the discomfort, but they do not correct the deformity.³ So, if you think insoles or exercises should be enough, these measures relieve but do not straighten a toe that is already deformed.

The cited sources do not detail the adverse effects of painkillers or anti-inflammatories for this problem, nor do they compare custom-made insoles with off-the-shelf ones, so there is no evidence here in favour of any paid option.

When is a claw toe or hammer toe operated on and what does surgery involve?

Surgery for claw toes, or the operation for a hammer toe, is considered in a serious case, when the joint needs to be straightened.¹ Surgery to realign the toe is one more option among those the professional assesses.² If you do not want surgery, the measures without surgery remain available, with the limitation that they do not correct the deformity.³

The operation aims to relieve pain, correct the deformity, prevent pain in the sole and other deformities and improve gait. There are several techniques and the procedure usually requires local anaesthetic.³ It often involves cutting or moving tendons and ligaments and sometimes removing or fusing the bones of the joint.¹

After the operation, most of the time the patient goes home the same day and can put weight on the heel, but for a while will not be able to push off or bend the toes when walking.¹ The toe is mobilised from the second day, and there may be pain in the wound for weeks or months.³

If you fear that the toe will be left stiff or shorter: it is a certain consequence of the correction. It shortens the operated toes and leaves an inability to move them properly that is usually temporary,³ and the toe may still be stiff and shorter after surgery.¹

These are the risks listed in the CGCOP informed consent:³

• Injury to vessels, nerves (with local pain or numbness of the toe) or tendons.³
• Thrombosis with swelling of the leg and, rarely, pulmonary embolism.³
• Wound infection.³
• Uncommon: recurrence of the deformity over time, skin necrosis, a painful or unsightly scar, reflex sympathetic dystrophy, Sudeck's syndrome and breakage or rejection of the fixation pin or screw.³

The cited sources do not quantify these risks or give the total duration of recovery.

When should you seek advice about a claw toe or hammer toe?

It is advisable to see a professional when these signs appear:¹

1. Signs of infection: sores or ulcers on the toes that become red and swollen, or redness that spreads up the leg.¹
2. Blisters or thick corns on the toes.¹
3. The pain gets worse.¹
4. Difficulty walking or wearing comfortable shoes.¹

As prevention, avoid footwear that is too short or narrow and check children's shoe sizes frequently.¹ If you have already had surgery, the CGCOP consent lists thrombosis with swelling of the leg and wound infection among the risks of the operation;³ the cited sources do not detail the warning signs after surgery, so if you notice swelling of the leg or problems with the wound, contact whoever operated on you.

This list is a guide and does not replace assessment by a health professional.