Toe Shortening
Toe Shortening
The procedure takes about 15 minutes per toe to remove a portion of one of the toe's small joints and insert bone pins. After 5-weeks patients can have the pins removed, both feet can be undertaken together. The major healing period for this procedure is about three to four months and the results should be lasting.
Surgical Procedure
The most critical part of the procedure is determining the appropriate amount and location of bone shortening. Even a few millimeters of shortening can make a significant visual difference. The shortening is performed at either of the two joints within the toe using a specialized bone cutting instrument. Depending upon the amount of bone shortening, a portion of the skin then needs to be remodelled or removed. After the internal shortening has been completed, a plastic sutured skin closure is performed. The new toe length and alignment is immediately evaluated.
Further useful information
The procedure can be performed under local anaesthesia in an outpatient surgical setting (hospital or surgical facility.); or as an inpatient under General Anaesthesia (GA). After the surgery the patient is able to walk carefully with full weight-bearing on both feet, without assistance. A special surgical shoe is provided. Approximately seven days after the surgery, the patient is seen for a dressing change. At two weeks post surgery, the patient is seen to remove the sutures. Suture removal is minimally uncomfortable.
During the first two weeks, in order to minimize swelling, decrease recovery time and produce the best results, ice packs should be applied and the feet should be elevated as much as possible. The results are usually permanent, functionally and cosmetically very pleasing; but it should be noted that there will be some loss of flexibility, however this will not affect your ability to exercise or play sports.
A moderate and gradually increasing amount of walking is allowing during the first two weeks after surgery. Pain medication is required for a few days post-surgery. A sandal or roomy trainer type shoes can be worn two weeks after the surgery. The pins are easily removed in the outpatient clinic at 5-weeks, without the need for anaesthetic. Swelling will persist for many months after surgery and you will have to modify your footwear to accommodate this. Driving is permitted after pin removal. We advise the use of various scar-care products, which can be discussed after surgery.
The 2 photos (bottom left) display shortening of the big toe for a female patient embarrassed about the length of the big toe. Some swelling remains at 3-months, which will resolve in time. The bottom right photos show shortening of the mid 3 toes (PLEASE CLICK ON THE IMAGE TO ENLARGE).
