Hammer Toe Surgical Treatment

A hammer toe is a deformity of the toes. The toes can curl under or to the side.

To treat a hammer toe contracture surgically will have the most successful results if performed by an experienced surgeon.

Dr. Gennady Kolodenker performs hammer toe surgery in orange county california. 

There are different surgical options when it comes to hammer toes.

Do you want pins sticking out of your toes vs internal metal that stays in forever vs. no hardware at all.

The advantage of hardware is that it keeps the toe from drifting over during the healing process.

Pins are taken out in the office and as much as you think this hurts, It does not. A little uncomfortable, but tolerable.

Internal hardware for hammer toe surgery will stay in unless for some reason it bothers the patient. This hardware is very difficult to remove once the bones have fused together.

Hammer toe surgery is usually very successful and majority of patients are very pleased with the outcome.

Cosmetic hammer toe surgery is not advised. I would recommend considering surgery on the hammer toe only if there is pain.

My plastic surgical technique for hammer toe surgery places the incision to heal naturally and make it look like it is part of normal skin lines.

For more questions contact Dr. Kolodenker in Southern California.

Subtalar Joint Coalition Treatment in Orange County

Dr. Gennady Kolodenker explains the different types of Subtalar Joint (STJ) Coalition.

Sometimes also referred to as talo-calcaneal joint coalition.

Dr. Gennady Kolodenker is a Foot and Ankle Podiatry Surgical Specialist in Orange County.

The Subtalar joint is made up of 3 different parts. Anterior, Posterior and Middle.

The joint parts are called facets.

The Middle Facet of the STJ is the most common one to form a coalition.

Coalition can be Fibrous or Osseous.

A fibrous coalition means that there is a scar between the two bones where there should normally be normal cartilage.

An osseous coalition means that the two bones are stuck together by in-growth of bone.

Treatment depends on the patient age, pain level, and amount of arthritis.

Diagnosis starts with a physical exam and an X-ray. An MRI or a CT scan might also be needed.

For a consult on treatment of STJ Coalition in Orange County or Southern California please contact 
Dr. Gennady Kolodenker

Home Stretching Program for Clubfoot (Talipes Equinovarus)

Home Program for Clubfoot (Talipes Equinovarus) 

The following is a home exercise program that consists of basic information on club foot and on recommended stretching and strengthening exercises.  The goal is to help regain and maintain the necessary range of motion in your infant’s foot and ankle. Upon discharge from the hospital, it is recommended that you follow-up with a podiatrist or orthopedic surgeon regarding continued treatment who specialize in pediatric clubfoot.   

Range of motion: Recommend completing range of motion exercises at least three times a day.  The goal is to hold each stretch at least 30 seconds however it will depend on the infant’s tolerance.  You may need to slowly move your infant’s foot into these positions in order for increased compliance by your infant.  It also may be easier if you are either holding your infant or someone else can hold them.  

1.) Eversion at the talocalcaneal/subtalar joint  

- Starting position: Lay infant on back. 

 

- Place one hand on the lower leg just above the foot and the other hand around the heel bone. Gently push the heel bone outwards.  You want the foot and lower leg to be in line, do not go past midline with the heel.  Be careful not to overstretch this joint. 

  

          

2.)  Abduction of the talonavicular/calcaneocuboid joints (transverse tarsal joint)

 

- Starting position: Lay infant on back.  

- Place one hand on the heel and the other hand just in front towards the toes.  Gently press the inside of the foot (your hand closest to the toes) outwards.  Do not go past neutral with this stretch.

3.)    Ankle dorsiflexion (Talocrural joint) – only perform if you can achieve neutral alignment of the infant’s foot

- Starting position: Lay child on back.  This should be performed both with the infant’s knee flexed and straightened in order to stretch both the gastroc and soleus muscles. Make sure the foot and ankle are in line. 

- Place one hand on the infant’s lower leg to stabilize and place the other hand on either side of the infant’s foot.  Then gently apply an upward force.  

Alternate handling: Place one hand on your baby's flexed knee.  Grasp your baby's foot with the palm of your other hand placing your index finger above the heel.  Now you can gently flex the ankle up with a gentle downward force on the heel.   

Activation of lateral muscles and dorsiflexors – stroking :

-          Lightly move your finger along the top and outer border of your infant’s foot.  Allow your infant time to activate their muscles between each stroke. 

-          Perform this exercise 10 times.

Weight bearing through the foot and ankle for proprioceptive input :

-          This exercise should only be performed if you can achieve neutral alignment with your infant’s foot.

-          Place your infant either on their side with the foot you want to be weight bearing through on top or on their back.  

-          Provide 10 gentle compressions through your infant’s knee or lower leg. 

        

Please be aware that it is important not to overstretch your infant’s foot and ankle. If you are unsure or have any questions, please ask for assistance.  

Written by: Lynda Kolodenker PT, DPT, CNT