Hammer toe occurs when there is a shortening of the tendon that controls toe movement. This causes the middle joint of the toe to be bent upward and the outer joint downwards. The misshapen toe resembles a hammer. A hammer toe correction is done to correct a toe deformity called a hammer toe .
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Reasons for Procedure
A hammer toe correction is considered when:
- Other treatments have failed to bring about results.
- The affected toe is in an awkward position and is causing pain.
- The deformity makes walking difficult.
- The position of the toe causes breakdown of skin. This can increase the risk of developing a bone infection.
Complications are rare, but no procedure is completely free of risk. If you are planning to have the correction, your doctor will review a list of possible complications, which may include:
- Excessive swelling, although the toe will normally be swollen for 4-8 weeks following surgery
- Anesthesia-related problems
- Recurrence of hammer toe
- Nerve or blood vessel injury to the toe
Factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Physical exam
Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
The day of the procedure:
- Arrange for a ride to and from the procedure.
- Arrange for help at home after the procedure.
- Wear comfortable clothing that is easy to remove.
Local anesthesia is often used. It will numb the area. Spinal anesthesia may also be used. This anesthesia will make your lower body numb.
Description of the Procedure
Several surgical options are available for hammer toe correction. Some corrections can be made with changes to soft tissue. Others need to be made to the bone or joint.
This is usually best in patients under 30, with limited toe deformity. A cut is made in the skin and the tendon is released. Sometimes it is reattached to a different area of the bone. The changes in soft tissue will allow the toe to relax and eliminate the deformity.
2 common methods of hammer toe correction on the bones themselves are joint arthroplasty and joint fusion. The type of procedure used depends on the deformity. A combination of procedures may be needed. In both cases, a cut in the skin is made over the toe joint.
During an arthroplasty, part of the bones on both sides of the middle toe joint may be removed. This will allow the toe to uncurl.
During a fusion, the ends of the toe bones are removed. The bones are then repositioned. The repositioning is usually held together with a pin placed within the bone. The pin may be removed after 3-4 weeks. Other changes to the anatomy of the foot due to the hammer toe may also be corrected at this time.
The incision will be closed with stitches. Dressings will be applied to hold the toe in proper position.
How Long Will It Take?
This depends on the procedure and the number of toes corrected.
Will It Hurt?
Anesthesia prevents pain during the surgery. You will be given medication to manage pain after the surgery.
Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include pain medications.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
When you return home, take these steps:
- Use crutches or wear a special open-toed, wooden-soled shoe, as directed by your doctor.
- Follow your doctor's instructions.
The corrected toe may be slightly longer or shorter than before surgery. The toe will not move as much as a normal toe. Expect some swelling and redness, which may last for several months. Your dressing may need to be adjusted as swelling decreases. If it appears that the deformity may recur, your doctor may choose to continue with dressings for another 2-4 weeks.
Call Your Doctor
Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Pain that you cannot control with the medications you have been given
In case of an emergency, call for emergency medical services right away.
The American Orthopaedic Society for Sports Medicine http://www.sportsmed.org
Ortho Info—American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org
Canadian Podiatric Medical Association http://www.podiatrycanada.org
Health Canada http://www.canada.ca
Hammer toe. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00160. Updated September 2012. Accessed February 7, 2018.
6/2/2011 DynaMed Plus Systematic Literature Surveillance https://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
- Reviewer: EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
- Review Date: 03/2018
- Update Date: 03/01/2013