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TENDON LENGTHENING FOR A TOE DEFORMITY

Method
Surgical lengthening of shortened flexor tendons to correct claw or hammer toes
Duration
15 to 30 minutes per toe
Recovery time
4 to 6 weeks

Tendon lengthening is a surgical procedure for treating claw, hammer or mallet toes in which the pull of a tendon has fixed the toe in a deformed position. By lengthening the flexor tendons (usually the long flexors) the aim is to relax the toe, correct the excessive bend and so avoid pain and pressure points.

What is a tendon lengthening at the toe?

How the operation proceeds

  • Small incision along the course of the affected tendon
  • The tendon is lengthened in a Z shape in its middle or distal part
  • Fixation of the new tendon length with an absorbable suture
  • Combination with a corrective osteotomy or an arthroplasty where needed
  • Closure of the wound, dressing and fitting of a forefoot offloading shoe

Rehabilitation after a tendon lengthening

Aftercare is usually straightforward and serves to let the repair heal reliably and to preserve the corrected position of the toe.

Phase I (0-2 weeks): protection and wound healing
  • Wearing a forefoot offloading shoe round the clock
  • Elevation of the foot to reduce swelling
  • No active bending of the toes
  • Wound checks and removal of sutures from day 10-14 where needed
Phase II (3-5 weeks): mobilisation and adjusting the load
  • Beginning partial weight-bearing in everyday life
  • Physiotherapy to mobilise the toe joints
  • Strengthening the muscles of the foot and co-ordination
  • Changing to normal footwear once medically cleared
Phase III (from week 6): return to everyday life and sport
  • Full loading and return to work and everyday life
  • Individual insoles where there are problems with pressure
  • Sporting activity such as cycling or swimming
  • Long-term monitoring of the position of the toe