Bone spurs of the toes most commonly occur on the fifth toe. They occur less frequently on the other toes. The areas of the fifth toe that can form bone spurs are the outside of the toe next to the toenail, the inside of the toe near the tip of the toe where the toe presses up against the fourth toe, and on the inside of the base of the fifth toe. When the spur is at the base of the fifth toe, it is often associated with a soft corn between the fourth and fifth toes (See surgical correction of soft corns). Bone spurs can also occur on the side of any toe. Bone spurs in the toes are associated with excessive pressure of the toes pressing on one another while wearing shoes.
Surgical correction consists of making a small incision near the spur and smoothing the bone with a rasp or power burr. Quite often, this can be accomplished thru an incision small enough to require a single stitch. When the spur is adjacent to the toenail, a small section of the toenail may also be removed. On occasion, the spurring on the fifth toe may be associated with a mild, flexible contracture or curving of the toe. When this is the case, an additional incision may be required to release the tendon in the bottom of the fifth toe.
If the spur is at the base of the fifth toe and associated with a soft corn, a different surgical procedure is performed (See surgical correction of soft corns). Bone spur surgery of the toes is generally performed in the doctor's office under a local anesthetic. A very small bandage is placed over the surgical site. Sometimes a Band-Aid may be used. Quite often, the patient will be given a post-operative shoe to wear until they can comfortably get into a normal shoe. The stitches stay in place for seven to ten days. During this time, the area should be kept dry to help prevent infection. Frequently, the surgeon will allow the patients to change their own bandage on a daily basis. The day of surgery, the patient should significantly limit their activity to reduce the risk of bleeding.
What to Expect Following the Surgery
It usually takes a few weeks for the surgical site to completely heal, and activities should be limited or kept within normal reason during this period of time. ""If the activity hurts, don't do it."" The time required to be off from work will depend upon the demands of the job and the type of shoe that must be worn at work. If the patient's work is relatively sedentary, and they can return to work in a post-operative shoe, then they can generally return to work the day following surgery. If work requires standing or walking long hours, or requires work boots or sung fitting dress shoes, time off from work may be ten to fourteen days or more.
Relatively few complications are associated with this type of surgery. Infection or reoccurrence of the bone spur can occur. If the patient is too active during the healing period, delays in healing is likely.
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