Hammertoe Surgery: A Brief Guide

Hammertoe is a pretty common foot ailment that causes one of the toes — usually the second, third, or fourth toe — to curl up into a hammer-like position. For some people, it is and remains a minor deformity and more of an annoyance than anything else. For others, though, it leads to ongoing pain and trouble even wearing shoes. If you have hammertoe and have started to develop some discomfort and other negative side effects related to the condition, then surgery may be your best bet for correcting it. Here's an overview of what that foot surgery would involve.

When is surgery necessary?

Not every case of hammertoe requires surgery, even if the patient is experiencing pain. If your toe is still flexible and you can straighten it with your fingers, then your podiatrist may want to try having you wear a splint and do toe-straightening exercises first. If this does not work within a few months, then they'll probably recommend surgery. 

If your toe is already rigid — in other words, if you cannot straighten the joint manually — then you've reached the point where surgery is really the only corrective option.

Where is the surgery performed?

Hammertoe surgery is usually performed by a podiatric surgeon, which is a podiatrist who specializes in surgical procedures. Sometimes it might be performed in a hospital, but it's more commonly performed in smaller ambulatory surgery centers. Most patients do not need general anesthesia for hammertoe surgery. Podiatrists typically use a regional anesthetic to numb the leg and foot.

How is the hammertoe corrected?

There are a few different strategies a surgeon can use to straighten out the toe. They may only need to do what is called a tendon transfer, during which they remove some tendon tissue from another joint and graft it into the affected toe's tendon, effectively lengthening that tendon so the toe can lie flat again. If the bone has reformed due to the hammertoe, which is common in toes that are completely rigid, then the surgeon may remove a bit of bone before cutting and lengthening the tendons. In really severe cases, the surgeon may actually fuse the affected joint together.

How long does it take to recover?

Most patients can go home the same day as their surgery. You'll be given a protective boot to wear for a few weeks. At first, you will walk with a crutch, but you will slowly wean yourself off of the crutch and should be able to walk independently within a month. You'll likely need to see a physical therapist to learn exercises that keep your toe flexible and prevent hammertoe from developing again.

Not all cases of hammertoe require surgery. But if your hammertoe is bothering you, it's definitely worth consulting a podiatric surgeon about your surgical treatment options.