Toe Lengthening
“The world’s only toe lengthening procedure; developed with 20 years of experience revising traditional hammertoe complications.”
Smart technique, revolutionary procedure.
Medicine has advanced far, but it’s still considered a practice. Doctors perform surgery to help their patients, but sometimes results don’t turn out as expected.
Reconstructing a toe that’s shortened because of prior surgery comes with it’s share of difficulties. Scar tissue formation and irregular anatomy are pitfalls on the way to a successful result. Until now, complications from legacy hammertoe surgery procedures have little if any solutions available (1).
To accomodate for the wide variety of complications, the surgical techniques we use are modeled after plastic surgical rotational tissue flaps, sequential staged lengthening and cosmetically focused closures. We even had to borrow some neat instruments from our friends in opthalmology.
All this adds up to a completely new way of doing things… Just as facial reconstruction patients regain their confidence with surgery, you deserve the same with your toes.
How we do it, and why we did it!
The Doctors Show – Toe Lengthening & Reconstruction
Dr. Sadrieh interviews with Drs. Stork and Orden on The Doctors Show about the the unique toe lengthening procedure he created. Unexpected complications from routinely performed hammertoe surgery called arthroplasty, can result in short toes. During this procedure, a portion of the head, of one of the bones in the toe is removed. The problem occurs when the fibrous growth that is supposed to maintain the toe, breaks down causing the toe to shrink.
Until the development of our procedure, the options were limited for patients who experienced these kind of complications. At evofoot, we may be able to custom tailor a solution for most short toes (2). You will learn how it can help resolve genetically short toes or complications from traditional procedures with the use of a custom made implant that provides length to restore the appearance of the problem toe.
“It’s all about the details. We obsess over the details.”
Functional foot surgery without an aesthetically pleasing result can lead to a disappointed patient. We develop all of our procedures merging the best of two specialties, advanced foot surgery with modern plastic surgical techniques.
No detail is too small, which is why we’ve also implemented the most advanced technologies to help get you better results. Think of it as foot surgery... for the 21st century.
“Plastic” Foot Surgery
Using the most advanced techniques, atraumatic soft tissue handling, sub-cuticular closure & topical silicone scar treatment, we’re able to deliver results that are only available at evo.
Silver Antimicrobials
Advanced dressings used to prevent infection. Slow release silver ions (Ag+) with absorbent alginate dressing reduces bacterial growth, reducing our infection rate to less than 1%. 
Stem Cell Therapy
Platelet Rich Plasma (PRP) stem cell application included in our procedures when needed. This will advance healing, and potentially reduce scar tissue formation.Every toe is special, and so are our implants.
There are many reasons for short toes, no two complications are the same. That’s why we had to create a custom tailored solution. The use of silastic spacer implants is common, but these implants sometimes fall short of addressing contracted toes that have lost more than 50% of their original length.
Minor hammertoe complication
K-Wires are used to hold either Arthroplasty or Arthrodesis procedures in place for 6-8 weeks. During this time the patient is required to keep the foot dry and dressed with bandages. Wires can break, bend or act as a portal for infection.
Major hammertoe failure
Current fixation techniques have incorporated internal fixation, however with screws that cross both the joints of the toe. This creates stiffness and an "un-natural" look and feel.
Genetic short toe
We utilize internal fixation systems that only require the fusion of one joint. This allows for a more natural appearance, and feeling. Internal fixation also reduces the recovery time compared to traditional wires.
Using that kind of technology in a brachymetatarsia patient isn’t even an option since the implants are designed for the toe, not the metatarsal.
Custom implants provide the flexibility of creating solutions for patients who have toes that have lost more than half their length (2).
The Post-op Experience
Modern procedures + Advanced systems = Shorter, more comfortable experience
Depending on healing time, the average patient will wear a post op shoe and keep their foot dry for 3 weeks. Once the skin is healed and the sutures are removed, you will wear an athletic shoe for 3 more weeks and transition to normal weight bearing. After week 8 or 12, when examination shows tissue consolidation around the implant, you can begin transitioning to normal activity and shoe wear (3).
For brachymetatarsia patients the initial recovery comparison is dramatic, which can be up to two and half months sooner than traditional techniques.
Finally we’re able to provide our patients an opportunity to resolve what used to be considered a final result!
Time before getting foot wet
The average time for skin to heal is 2-3 weeks. Once the incisions are healed you can get your foot wet.
Time before resuming normal activity
After the 4th or 5th week, when x-rays show quality bone healing, you can begin transitioning to normal activity (4).
Special Features
Simpler Recovery
Our procedures are designed to help get the patient back to life faster than traditional foot surgeries. On average patients wear a surgical shoe for 2 weeks, and athletic shoes for 2 more weeks. During the recovery time, the patient is functional and able return to the majority of their day to day tasks.
Complimentary Concierge
Coordinating a surgical procedure is complicated. Our patient concierge is there for you. To answer all of your questions, and take care of all the things you need, to feel confident and supported in your endeavor. At evo, you’re not alone.
Surgeon Access
The key word in the “patient doctor relationship” is relationship… and every healthy relationship is based on communication. It’s why we’ve always been directly available to our patients, 24 hours a day, 7 days a week. No answering service, no barriers. Send message here
Included Accessories
We take our craft seriously, and appreciate that part of your success, is having the resources you need to heal without challenges. So all our patients receive a complimentary post op kit that includes all the tools they need to succeed. It’s our gift to you, for the privilege of serving you. Learn more about the post op kit here.
Premium Experience
In today’s high speed world, it’s refreshing to work with companies that value people more than time clocks. This has been one of the core principles at evo form the beginning. We schedule linear, not stacked. Every one of our patients is a VIP… concierge medicine, without the concierge fee.
Financial Options
The financial landscape of healthcare is always changing, and not in the favor of the patient. We believe that everyone deserves an evo foot, so we have multiple options for our patients, from using their health insurance for covered procedures, to using low or no interest payment plans. Regardless of the challenges, we’re here to help you experience the evo way.
Important Notes
(1) The term “legacy” used in reference to procedures that use traditional K-Wire fixation and incisions on top of the toe.
(2) Consultation with evaluation of history, actual toe and x-rays are needed to determine if you are a candidate for this procedure, and how much length/restoration can be obtained.
(3) Encapsulation of the implant needs to occur before acticity can resume to normal, the time for this varies between patients and can be based on the extent of your deformity and history.
(a) Average patient recovery compared to traditional techniques that require bone lengthening with external fixation, bone grafting, or cast immobilization.
(b) Incision must be healed before sutures can be taken out and foot can get wet, this time can vary.
(c) Implant encapsulation, inflammatory response and swelling and tissue contracture/scarring can increase this time, steps will be taken to reduce if symptoms present.
Schedule a consultation.
The best way to experience evo, is in person. We’re confident that your consultation will be second to none. Our team will follow up with you to complete the on-boarding process.