Beth’s pain in her feet got to the point where she could barely walk a few blocks without experiencing severe discomfort. Beth suffered from a hammertoe in her right foot and intense stiffness and arthritis in the big toe joint of her left foot.
When she couldn’t bear the pain anymore, Beth turned to Daniel L. Wiernik, D.P.M., a board-certified foot and ankle surgeon specializing in podiatry and reconstructive rearfoot/ankle surgery at Orlando Orthopaedic Center.
Together Beth and Dr. Wiernik determined that double foot surgery would give her the greatest chance of success. “I had two surgeries, one a year ago and one six months ago,” says Beth. “The best thing that came out of surgery was that I have my quality of life back. I went from not being able to walk more than a half of a mile without being in excruciating pain to now walking several miles, being able to play tennis again, and having a much better quality of life.”
Beth’s first procedure was on her left foot and involved an arthrodesis of the first metatarsophalangeal joint (MPJ), which is the surgical immobilization of the big toe joint by fusing it with the adjacent bone. The arthrodesis was combined with a metatarsal osteotomy of the 2nd toe (next to the big toe). The metatarsal is the long bone in the foot that connects the toe to the middle of the foot. An osteotomy is when a surgeon cuts and shortens the second metatarsal to reduce pain and allow the toe to straighten.
What is a Hammertoe?
A hammertoe is a deformity causing the toe to bend upward at its midpoint often resembling a hammer. Hammertoes typically begin with weak or unbalanced muscles and often come about by wearing poor-fitting, compressed, high-heeled shoes. As the front part of the foot is pressed down and forward into the shoe, the muscles and tendons of the toe weaken, causing disfigurement over time. Corns and calluses can also develop further aggravating the situation.
Individuals with longer toe bones, prone to toe injuries, and who have rheumatoid arthritis are more likely to develop hammertoes.
Reconstructing the arm after a severe dog bite can often require a number of surgeries over time to gradually restore the skin, muscles, tendons and nerves that may have been damaged. The normal reconstructive protocol begins by irrigating and cleaning the wound, stabilizing the bone, restoring vascular flow, and repairing nerves, tendons, and closing the wound or covering the soft tissue losses. Skin grafting, local and distant flaps, and microsurgery may be used to replace any loss of flesh.
Immediately following her traumatic injury, Dr. Riggenbach performed reconstructive surgery on the outer flap of Maria’s right arm to seal the wound. This was followed by a second debulking surgery eight months later in which areas of bulky skin and fat were smoothed out.
“He was trying to save my arm,” says Maria. “He tried to put everything back as much as possible. It got infected so he wanted to do other surgeries to repair it. I’m glad he took extra steps.”
Treatments for Hammertoe
In its early stages, if the toe has some degree of flexibility, non-surgical treatments may reduce the pain and swelling, and allow some semblance of normal activity. These include:
- Exercises to strengthen the toe
- Applying ice packs to reduce pain and inflammation
- Wearing loose fitting shoes
- Using custom orthotic devices or placing a pad around the affected toe to avoid rubbing against the shoe
However, if the toe is rigid or unmoveable with a high degree of discomfort, surgery may be necessary to improve the situation.
Beth appreciated the fact that Dr. Wiernik never put pressure on her to have surgery despite the severity of her condition. “I’m so grateful for that because the best thing about him is that I’ve been seeing him for a couple of years, and he never forced me into surgery,” says Beth. “He would say ‘how are you feeling,’ and I would say ‘It’s horrible. I’m in so much pain all the time.’ Then he would say ‘Well, I’ll give you a cortisone shot but it’s probably not going to help you too much. I think I can take care of your feet but it’s up to you.’”
“For about a year, I kept coming in every couple of months and got a cortisone shot in both my feet,” Beth continues. “Eventually, I told Dr. Wiernik ‘I have zero quality of life. I’m ready for a change, and I’m ready to take a chance.”
Surgery for Hammertoe
Beth decided to opt for surgery in the hope that it would provide a more permanent solution for her pain. “That’s what I did. (Dr. Wiernik) always said my feet were extraordinary – I think that’s because they were so horrible – it presented a good challenge for him,” Beth says.
Six months after the surgery on her left foot, it was time to correct and heal the hammertoe on her right foot. Beth underwent another arthrodesis of the first metatarsophalangeal joint (MPJ) with a hammertoe correction procedure on the 2nd toe.
“(Dr. Wiernik) was wonderful. He fixed my feet and I’m very grateful. I think you have to be comfortable with your doctor, comfortable with the person that is going to do surgery on you. I felt very comfortable with him, and I knew he was going to do what was best for me. And he did.”
After her successful foot surgeries, Beth wholeheartedly recommends Dr. Wiernik and his staff to anyone needing similar treatment. “Come in – run, walk, crawl, make an appointment,” says Beth. “I feel like you can’t go wrong. It’s so important. It’s your life. How long do you want to suffer? How long do you not want to have a quality of life? (Dr. Wiernik) can help you with that. I think he’s wonderful.”