What Is Hammertoe Surgery?
A hammertoe is a deformity that causes a toe to become bent upward
in the middle so it resembles a hammer. This can cause the toe to rub against the top of the shoe or irritate the end of the toe by jamming it into the ground. Hammertoes often occur in conjunction with other toe problems. It is possible to develop
corns (calluses) on top of the middle joint of the hammertoe from rubbing against the top of the shoe.
Patients who have hammertoes try to manage them by treating the symptoms. This involves padding the toe and changing or stretching shoes for comfort. If you still experience discomfort from the hammertoe you may consider surgery.
The hammertoe can be flexible or stiff. Depending on the flexibility of the toe and the preference of your orthopaedic foot and ankle surgeon, several different surgeries are used to treat the hammertoe.
If you have pain or cannot comfortably wear shoes after trying non-surgical treatments, hammertoe surgery may be an option.
Patients with other toe problems in addition to the hammertoe should avoid surgery for just the hammertoe alone. Additional surgery may be needed to address the other deformities as well. Other reasons to avoid hammertoe surgery include active infections,
poor circulation, and any serious illness that would make surgery unsafe. You should discuss your health history with your orthopaedic surgeon prior to considering hammertoe surgery.
Most often, hammertoe correction is done as an outpatient procedure, meaning the patient can go home the same day. You may be fully asleep during surgery or simply given an injection (nerve block) that makes the foot go numb temporarily.
Flexible Hammertoe: This means that the toe can be easily straightened during your examination with a foot and ankle orthopaedic surgeon. If your hammertoe is flexible and your surgeon can straighten the toe, a tendon transfer procedure may be used to correct the problem. This involves rerouting the tendons from the bottom of the toe to the top of the toe where it is sticking up. This helps straighten the joint. Occasionally, a joint at the base of the toe needs to be released
as well to allow the toe to lay completely straight.
Fixed Hammertoe: This means your toe is unable to be straightened by the foot and ankle orthopaedic surgeon during the examination. If your hammertoe has become fixed
(stiff), there are two options for treatment. Removing the rigid joint can treat the fixed hammertoe. In this procedure an incision is made over the top of the toe. Ligaments and tendons may be cut to help with straightening the toe. The end of
the bone at the fixed joint is removed to allow the toe to straighten completely and pins are used temporarily to hold the toe straight. The pins are usually removed three to four weeks after the surgery.
A fusion also can treat a fixed
hammertoe. In this procedure, the ligaments and tendons are cut to help straighten the toe. The ends of the bone at the fixed joint are cut and the toe is straightened. Pins, screws, or other implants are used to keep the toe straight while the
bone ends heal together.
Just like the flexible hammertoe treatment, both fixed hammertoe options may require release of the joint at the base of the toe to allow the toe to lay completely flat.
You may be given a special shoe to wear after surgery to help with walking. Recovery usually takes a few weeks depending on the type of surgery that was done. You will be asked to keep your foot elevated at the level of your heart for the first few weeks
after surgery, which requires lying on a couch or bed with your foot up. You also may need crutches or a walker after surgery depending on your ability to walk.
Stitches usually are removed two to three weeks after surgery, and if pins
were placed, these will be taken out within a few weeks. You may not put your foot under water until the stitches and pins are removed.
If the hammertoe is on your right foot, you may not be able to drive a car for a number of weeks depending
on the type of surgery you have.
Your orthopaedic surgeon may ask you to do exercises to stretch and move the toe at home after surgery. This can help with flexibility of the toe and to maintain motion in the toe.
It is normal
to have swelling after surgery. It may take up to one year before the swelling resolves.
Risks and Complications
All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots.
Complications specific to hammertoe surgery include a small chance that
the hammertoe may come back after your surgery. There is a risk that after the surgery you may feel like the toe is unstable. This is due to the cutting of ligaments and tendons. The risk is small because pins are used to hold the toe in place for
a few weeks while the toe heals. If you have a fusion there is a small risk of the bones not healing. These complications are rare. Discuss the potential complications with your orthopaedic surgeon prior to undergoing hammertoe correction.
If I am treated with surgery will the hammertoe ever come back?
It is possible that after surgery your hammertoe may come back. If this happens and you have discomfort in the toe, an additional surgery may be needed to address the
Can I bend my toe after surgery?
Depending on the specific surgery used, you may or may not be able to bend your toe once it has healed. Ask your foot and ankle orthopaedic surgeon what type of surgery is needed for your hammertoe.
The American Orthopaedic Foot & Ankle Society (AOFAS) offers information on this site as an educational service. The content of FootCareMD, including text, images, and graphics, is for informational purposes only. The content is not intended to substitute
for professional medical advice, diagnoses or treatments. If you need medical advice, use the "Find a Surgeon" search to locate a foot and ankle orthopaedic surgeon in your area.