Hammer toe repair

Several kinds of surgery can repair hammer toe. Your bone or foot doctor will recommend the kind that will work best for you. Some of the surgeries include:

• Removing parts of bones in the toe
• Cutting or transplanting the tendons of the toes (tendons connect bone to muscle)
• Fusing the joint together to make the toe straight but no longer able to bend

After surgery, surgical pins or a wire (Kirschner, or K-wire) are used to hold the toe bones in place while your toe heals. You will be asked to use a different shoe to walk to allow your toes to heal. The pins will be removed in a few weeks.

When hammer toe starts to develop, you may still be able to straighten your toe. Over time, your toe may get stuck in a bent position and you can no longer straighten it. When this happens, painful, hard corns (thick, callused skin) can build up on the top and bottom of your toe and rub against your shoe.

Hammer toe surgery is not done just to make your toe look better. Consider surgery if your hammer toe is stuck in a flexed position and is causing:

• Pain
• Irritation
• Sores that can lead to infection
• Problems finding shoes that fit
• Skin infections

Surgery may not be advised if:

• Treatment with paddings and strapping works
• You can still straighten your toe
• Changing to different shoe types can relieve symptoms

Risks of anesthesia and surgery in general are:

• Reactions to medicines
• Breathing problems
• Bleeding
• Blood clots
• Infection

Risks of hammer toe surgery are:

• Poor alignment of the toe
• Pain around your toe
• Injury to nerves that could cause numbness in your toe
• Scar from surgery that hurts when it is touched
• Stiffness in the toe or a toe that is too straight
• Shortening of the toe
• Loss of blood supply to the toe
• Changes in appearance of your toes

Tell your surgeon or nurse if:

• You are or could be pregnant
• You are taking any medicines, including medicines, drugs, supplements, or herbs you bought without a prescription
• You have been drinking a lot of alcohol, more than 1 or 2 drinks a day

Planning for your surgery:

• If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see the health care provider who treats you for these conditions.
• If you smoke, it's important to cut back or quit. Smoking can slow healing and increase the risk for blood clots. Ask your provider for help quitting smoking.
• If needed, prepare your home to make it easier to recover after surgery.
• Ask your surgeon if you need to arrange to have someone drive you home after your surgery.

During the week before your surgery:

• You may be asked to temporarily stop taking medicines that keep your blood from clotting. These medicines are called blood thinners. This includes over-the-counter medicines and supplements such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and vitamin E. Many prescription medicines are also blood thinners.
• Ask your surgeon which medicines you should still take on the day of surgery.
• Let your surgeon know about any illness you may have before your surgery. This includes COVID-19, a cold, flu, fever, herpes outbreak, or other illness. If you do get sick, your surgery may need to be postponed.

On the day of surgery:

• Follow instructions about when to stop eating and drinking.
• Take the medicines your surgeon told you to take with a small sip of water.
• Follow instructions on when to arrive at the hospital. Be sure to arrive on time.

Most people go home the same day they have hammer toe surgery. Your surgeon will tell you how to take care of yourself at home after surgery.

Flexion contracture of the toe

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Updated by: C. Benjamin Ma, MD, Chair, Department of Orthopaedic Surgery, Dr. Peter and Sophie Pappas Endowed Chair, V-nee Yeh Endowed Professor of Orthopaedic Surgery, University of California, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.