Patients of all ages regain mobility and function with routine surgery
The foot and ankle specialists at Emory Orthopaedics & Spine Center have been researching the best ways to treat toe and forefoot deformities for more than seven years. Together, the team compares techniques, reviews complex cases, and tracks patient results. They are particularly interested in studying the outcomes of geriatric patients after bunion and hammertoe corrections because this population tends to believe surgery isn’t really an option. Older patients often live with pain and loss of mobility for years before seeking help.
Emory research has proven that bunion and hammertoe corrections are highly beneficial for older patients; their outcomes are similar to younger patients with no increase in complications. Both young and old report a dramatic reduction in pain, better shoe wear, more mobility and an increased ability to exercise. This, in turn, helps them return to living fuller, healthier and more active lives.
Who to Refer
Most patients begin having forefoot issues in their 40s and 50s. The symptoms generally start out as mild irritations. For instance, patients may complain their toes rub against their shoes, making them uncomfortable to wear. As conditions progress, patients may develop tenderness, callouses and joint pain on their feet from malalignment. They begin adapting their daily activities to accommodate the discomfort, writing off their symptoms as a sign of aging. This is concerning because, as symptoms get worse, patients become less likely to exercise and stay active. Eventually, this puts them at risk for much more serious health problems.
Foot pain is not normal at any age, and the sooner patients can visit an orthopedic specialist at Emory Orthopaedics & Spine Center, the better. If diagnosed early enough, they may be able to eliminate soreness and return to their normal routines with simple non-operative treatments, like spacers or footwear modification. If not, routine surgery can get them back on their feet in no time.
However, many patients wait so long to see an orthopedic specialist that they become devastated by the pain from their bunions and hammertoes. Even though their ability to exercise, or even walk, becomes limited, many patients in their 60s and 70s believe they are too old to have surgery. But, that’s exactly what they need in order to maintain good overall health. Weight gain, depression, arthritis and hip pain are just a few potential consequences of ignoring the problem. Only patients who are considered high risk under anesthesia (because of other serious health issues, such as diabetes or heart conditions) are turned away for corrective procedures.
Bunion & Hammertoe Surgery
Bunion and hammertoe corrections are performed on an outpatient basis. The specialists at Emory Orthopaedics & Spine Center realign bunions using either an osteotomy or a fusion, depending on the circumstances. To correct the hammertoe, the joints in the toe are removed and tendons are cut so the toes can be pinned straight to give the patient as much functionality as possible.
After surgery, patients avoid putting weight on the front of their feet for about six weeks by walking on their heels. This is usually followed by two weeks of full weight bearing in a special boot. By week eight, patients should be walking again in their own shoes and able to start non-impact exercise. At the three-month checkup, most patients are cleared to resume all of their favorite activities.
Each of the foot and ankle patients at Emory is given a pre- and post- operative survey. The surgeons track reported outcomes and use their findings to apply the most effective techniques in every situation. They always strive to use the least invasive methods to achieve the best possible results.
Pre- and post-operative X-rays often reveal a significant change in the look of the feet. The images below are of a 72-year-old female patient who presented with significant forefoot pain and an advanced clinical and radiographic deformity. The patient underwent successful forefoot reconstruction after failing conservative treatments with shoewear modification, including shoe inserts and toe spacers. Surgery resulted in a significant reduction in the patient’s pain as well as a significant improvement in mobility, which allowed her to actively return to all the activities she wanted to perform.
Before forefoot reconstruction
After forefoot reconstruction
How to Refer
To refer a patient for a toe and forefoot evaluation, call the Emory Orthopaedics & Spine Center at 404-778-3350. A representative from Emory Healthcare will help schedule an appointment.
Emory Orthopaedics & Spine Center is committed is committed to the continued health and safety of all patients. During this time, we are taking all necessary precautions to screen for coronavirus (COVID-19) and to prevent its potential spread. We continue to monitor the evolving COVID-19 pandemic and are working with experts throughout Emory Healthcare to keep your patients safe. For the most up-to date information for our referring partners, click here.
Read the Research
If you’d like to learn more about the research conducted by foot and ankle specialists from the Emory Orthopaedics & Spine Center, check out these articles posted with the U.S. National Library of Medicine:
Effect of Age on Complication Rates and Outcomes Following First Metatarsophalangeal Arthrodesis for Hallux Rigidus.
Lunati MP, Manz WJ, Maidman SD, Kukowski NR, Mignemi D, Bariteau JT.
Foot Ankle Int. 2020 Nov;41(11):1347-1354. doi: 10.1177/1071100720942140. Epub 2020 Aug 14.
Mobility Limitation After Surgery for Degenerative Pathology of the Ankle, Hindfoot, and Midfoot vs Total Hip Arthroplasty.
Kurkis G, Erwood A, Maidman SD, Manz WJ, Nazzal E, Bradbury TL, Bariteau JT.
Foot Ankle Int. 2020 May;41(5):501-507. doi: 10.1177/1071100720907034. Epub 2020 Mar 4.
Foot Width Changes Following Hallux Valgus Surgery.
Tenenbaum SA, Herman A, Bruck N, Bariteau JT, Thein R, Coifman O.
Foot Ankle Int. 2018 Nov;39(11):1272-1277. doi: 10.1177/1071100718783458. Epub 2018 Jun 28.
Complication Rates and Short-Term Outcomes After Operative Hammertoe Correction in Older Patients.
Mueller CM, Boden SA, Boden AL, Maidman SD, Cutler A, Mignemi D, Bariteau J.
Foot Ankle Int. 2018 Jun;39(6):681-688. doi: 10.1177/1071100718755472. Epub 2018 Feb 15.
Foot Width Changes Following Hallux Valgus Surgery.
Shay Tenenbaum, MD, Jason Bariteau, MD, Amir Herman, MD, Oded Coifman, MD Foot & Ankle Orthopaedics, vol. 3, 3, First Published September 18, 2018.
Complications Rates and Outcomes Following First Metatarsophalangeal Arthrodesis for Hallux Rigidus: Does Age Matter?
Matthew Lunati, Wesley J. Manz, Samuel D. Maidman, BA, Danielle Mignemi, ATC, Jason T. Bariteau, MD
Foot & Ankle Orthopaedics, vol. 5, 4, First Published November 6, 2020.