Is tenotomy a good option?

[Giovi1960]

Has anybody heard about tenotomy for hammer toes? I would like to hear from anybody who has had that procedure done to aliviate the bending of the toes.

[docjleonard55]

Hi Giovi, I am a retired Podiatrist. I never had the procedure done, but of course have done some. A tenotomy is a decent procedure for a hammertoe , but depends on the severity of the deformity. I wouldn't do one on severely hammered toes, or ones that have been present for a long time. The other thing you have to be aware of is potential complications. After tenotomy, the toe can straighten out somewhat and the tendon ends grow back together in an elongated position. However, if the ends do not reconnect, it could lead to a floppy toe.

[Giovi1960 in reply to docjleonard55]

Thanks so much for the information, Dr Leonard (I hope I got that right?). May I bother you with more questions?

[docjleonard55 in reply to Giovi1960]

You are welcome to ask me any questions.

[Giovi1960 in reply to docjleonard55]

Thanks Jonathan. Just a couple of questions (for the time being 🙂). How high a re the probabilities of ends not reconnecting? And.. What would be the complications of having a floppy toe (walking, balance, cycling, etc.?)?

[docjleonard55 in reply to Giovi1960]

I can't honestly say I know the percentage of failure of the surgery (probably small). The consequences are not really that earthshaking. Depending on which toe it is, there is potential for a change in gait (small) or balance issue (small). The major issues are the toe getting caught putting on socks, sandals etc., and long term issues like secondary deviation of other toes (moderate), which can lead to gait (moderate) or balance disturbances (small).

[Giovi1960 in reply to docjleonard55]

Well, I am having problems with the 3 toes between big toe and pinky. I am trying some exercises but there are days when they bother me a lot. Not so much pain. Would you suggest operating 3 toes on the same foot? I know it's difficult to say without "seeing the foot" 🙂. So I am just asking for an expert opinion in order to learn about the procedure and make an informed decision. Regards

[docjleonard55 in reply to Giovi1960]

Should be OK. Operating on 3 toes at one time is not uncommon.

[Giovi1960 in reply to docjleonard55]

Thanks again, Jonathan. Have a nice weekend.

[docjleonard55]

And please, call me Jonathan. I am retired.

[Erniediaz1018 in reply to docjleonard55]

Hi Jonathan, thank you for the feedback. Do you have any suggestions for curling toes due to Parkinson’s which I can do myself.

[Giovi1960 in reply to Erniediaz1018]

Hello Erniediaz1018 , I found this video on YouTube. If you go to YouTube and search for "exercises for hammertoes" you will find some that may work for you. youtu.be/whOS9-Nrw84(Not working as expected?)

[Erniediaz1018 in reply to Giovi1960]

Thank you, excellent video. I do own the toe separators from correct toes and it brings relief, but had Never seen this video

[Giovi1960 in reply to Erniediaz1018]

There are a few interesting videos. I hope they help so I can avoid the operation.

[docjleonard55]

Nothing really. This is not a podiatric or orthopedic issue.

[Debgiffen]

I had tenotomy performed on 3 of my toes on my left foot which is my PD afflicted side. For several years before my PD diagnosis I has severe gripping of my toes caused by balance issues. Any time I felt unsteady my toes would grip like a monkey grabbing a tree branch. Every step was so painful so I had the tenotomy to relieve the pain. It did help with the pain from gripping but I had already damaged the toe joint so ended up joints removed and had screws inserted about 6 months later.

That was about 7 years ago. I don't have floppy toes but I need to keep toenails cut short because they tend to point upward a bit. I can move my toes up and down but I can't curl them under. Neither procedure has slowed me down. After having great success with high dose thiamine, I now hike/walk 4-5 miles several times a week, garden, climb ladders, do yoga,etc. Occasionally I have pain in one or more toes but I think that's more related to the screws then the tenotomy.

[Giovi1960 in reply to Debgiffen]

That's encouraging, Debgiffen. Though I must admit the idea of having screws on my toes makes me feel faint. You're brave!

[jeeves19]

Giovi. Did you get your issues with your toes sorted ? I had two of mine fused about 3 months ago. It’s been a nightmare as they wouldn’t let me exercise for ages afterwards and consequently my PD symptoms started to overwhelm me. I’m getting back to some sense of normality now but the problem is that the ‘ring’ toe (4th) and pinkie are both now permanently in the grip position and walking is very uncomfortable. Strangely I’ve noticed that I’m having a similar process occurring on the right toe on my other foot. I’ve been referred to the surgical team to straighten the offending toes but wonder where all of this is going to end? Will I end up having all of my toes fused?! 😩

[Giovi1960 in reply to jeeves19]

Hi jeeves19, sorry to hear about your toes problems. I decided not to go for surgery as my podiatrist said the problem may come back as it's a symptom of the illness. I am using a toe separator to release some of the stiffness and gripping on the toes. It's made of gel and seems to help some. My pinkies are very stiff on the gripping position sometimes so I try to stretch all my toes and massage them as often as i can. Also, walking on my tiptoes helps.

[Giovi1960 in reply to jeeves19]

Jeeves, this is the toes separator I use, the one that is all closed on the top:

a.co/d/9ManfNO

[jeeves19]

Thanks for getting back to me on this. Do you find that the gel stuff is firm enough to keep your toes in a required position? Also, when do you wear them?

[Giovi1960]

Hi Jeeves, even though the toe separator doesn't keep my toes as straight as I would like, it keeps them separated and more relaxed. It takes a little time to get used to walking wearing them and you can not wear shoes as they are quite bulky, so I wear them anytime when I am home and when I feel my toes are starting to bend.