a

Quick Fix Hammertoe

hey everyone dr. Leo Crouch here I've

got a unique case here I have an 82 year

old patient with me right now who has a

really bad hammer toe the problem with

the hammer toe is it's so rigid it's

rubbing on her shoes so she could only

wear open-toed shoes which is great in

Florida but sometimes it does get cold

like today it's under 70 degrees so it's

a little bit cold for people like me who

get used to the hot weather and people

like my patient who's 83 years old and

doesn't like the cold and doesn't want

to wear open-toed shoes so what do we

have to do we have to get this toe down

just a little bit because it's

contracted upward

so I'm gonna take a dump in have a look

at this flow right here and you can see

you can see how it's up in the air

compared to the other ones and this is

what keeps rubbing and that keeps

opening up into an open sore so if we

were to go in and make an incision

across here take this the court applied

tissue out of there and try to silver up

she has a high chance because of her age

of not healing or having the wound es

which means that the wound would open up

and not heal completely and she'd have a

major issue so our goal today is really

can we get this toe to drop down just a

little bit so it's kind of hanging on

there so she can wear a clothes shoe if

you look at this foot over here it was

done on this foot I believe where she

does not have that issue you can see

even though did you have that procedure

understudy up no but it's just low

enough and you can see how it's dropped

down that it doesn't bother her but this

disc this is still contracted a little

bit here but it's not bothering or

because it doesn't hit the top of the

shoe it doesn't open off this one is

just severe so we're gonna try this

sometimes once in a while it doesn't

give her the full result and we have to

just accommodate by having a wear an

open toe shoe or shoe with a real wide

toe box at the metatarsal phalangeal

joint which is right I can actually feel

the tendon here and I'm gonna have her

do something hit pull your toe towards

her nose this toe right here so we can

naturally see the tendon pull it as hard

as you can as hard as you can and that

way I can feel the time in the tendon

this is the extensor tendon comes down

here and the joint itself is right here

okay you can realize that and what I'm

gonna do it I'm gonna make a stab

incision right in that area right here

and we're gonna cut that tendon actually

so I'm gonna make the Stabbin sit in

this way for healing purposes it'll if

if this if this toe bands it won't meet

the little wound gap open so I'm gonna

stab incision right here and I've

already known to rob so now what I'm

gonna do is I turn my blade okay and I'm

that joint look I'm gonna put it back

yard at the level joint and I'm gonna go

ahead and I'm gonna snap this down them

so you can sometimes hear it you hear

that it sounds like celery the patient

here is a cow and I'm going I'm right on

the top of the joint right now so I'm

gonna make sure I get the whole tendon

and I'm gonna have you try to pull your

toe towards your nose a gap so she's now

it's harder for because I'm snapped it

so we're gonna make sure we get every

bit of that sometimes you only get a

little bit of it and it doesn't snap

completely no pain correct okay okay and

I'm gonna go side to side I'm right over

the top of Jo and I can actually feel

the joint us-south here and we're gonna

cut the joint itself - that's called a

capsulotomy go ahead and try to pull out

a gun and there's a little bit more

that's needs to be caught there we go

yeah that's on the top of the joint that

was the joint in style great and try to

pull it out hey Paul Paul Paul and you

see she's trying to pull right now

because the tenant snap try to pull it

okay good

and yeah so we're hoping that she can't

feel anything yeah and one that you

can't pull it up so now I'm gonna have

you pull your toes toward your nose

again so it comes up a little but you

can barely put there's nothing really

coming up it's really the other ones and

they contracture the skin that's pulling

that on so you see how that toe is

dropped now yeah I see the difference so

if the toe is dropped so we got it out

of the way I'm gonna have you up and

down again so you can see it again now

wiggle your toes for everybody so she's

wiggling and what's happening is his

skin and the other toes that are making

a move but the reality of it is with a

shoe on here and if you look at can you

see how my hand is here over it it's not

gonna push on that anymore there's more

of a gap right there so this is gonna be

great when it heals I'm gonna bomb in a

bandage this in a position like this

over Crafton okay

and the patient says good great and I'm

gonna do that because when it heals this

area right here right cut the tendon

this will actually grow back together

but it'll be in a lengthened position

and it won't be as strong so you might

be able to move it up a little bit but

not as much but this is gonna actually

help the situation and we're gonna

revisit this probably in a month or so

so you can see how this feels off maybe

maybe six weeks so we can actually see

how this is doing in this should

actually look better and better everyday

if you look closely you can see that's

where she was getting you open torn and

so somewhat rod net area right and it's

still painful

yep okay so I'm gonna be sure to put a

little bit of baby over the hole in that

hole in the hole and we're gonna get a

little bit of bait in there

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now we don't want any kind of animals

licking this that would not be for some

reason animals are attracted to wounds

they must smell the blood or something

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always in the house put up and you could

see her skins real thin you see what's

happening there I was kind of bunching

up a tiny bit there we're gonna throw

this one suture this should be good and

this is some nylon that we're using

nylon suits right here I'm gonna have my

camera person actually cut this there we

go some bigger than normal suture than

we would use okay right there and then

cut the other piece so we're gonna give

this a little haircut here yeah okay

so now we have a straighter toe try to

wiggle your tail one more time good so

really it's very weak it's out of the

way okay we'll do a follow-up video like

I said in probably four to six weeks so

you can see how it is she's gonna be

really happy with this cuz she'll be

able to wear clothes didn't shoe

starting in three days which is great

she'll be able to get into a shoe I'll

probably ever wearing open to toe tuck

the shoe it just comes in a week and

then we're gonna bathroom your clothes

and shoe as long as I see that this skin

to your top and that's it so this is a

very quick easy way to get rid of the

problem doesn't make the toe look pretty

but it does give it out of the way and

she's more functional and she'll be very

happy

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