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A hammertoe is a deformity that causes the toe to bend downward, causing it to resemble a hammer. Hammertoes develop as a result of genetics but can become worse after wearing improper shoe gear that causes the toes to crowd in the shoes. In most cases, hammertoes are not painful. However, in some cases, they can be.
Sometimes, hammertoes can cause painful sores to develop on the tops and sides of the toes from irritation against shoe gear. In these cases, surgery may be indicated to straighten the toe and relieve pressure at the joint.
This article will focus on surgical repair for hammertoe deformities.
To learn more about what causes hammertoes check out this supplemental post: 7 Things You Didn’t Know That May Have Caused Your Hammertoes.
Hammertoe Procedure Surgery- What to Expect
There are different types of hammertoe surgery that can be performed, depending on the severity of the deformity.
Flexor Tenotomy Hammertoe Surgery
For mild flexible hammertoes, a simple flexor tenotomy procedure can be performed in the office. The flexor tendon (on the underside) of your toe flexes the toe down.
Your doctor will use a small needle to inject a local anesthetic into your toe to keep the toe numb for several hours. Then a larger needle will be used to release the flexor tendon on the bottom of the toe to relieve contracture. A dressing will be applied.
This procedure does not straighten the toe completely but does help relieve pressure along the tip of the toe. Say you have a painful corn or ulcer on the tip of your toe, this procedure can help relieve pressure and heal the sore.
Recovery After Flexor Tenotomy- What to Expect
You can walk in an athletic shoe immediately after the procedure. Other than mild swelling and bruising, recovery is fairly quick.
Arthroplasty Hammertoe Surgery
Arthroplasty hammertoe surgery is a procedure in which the toe joint is surgically reconstructed to correct the deformity. An arthroplasty will have to be performed in the operating room under sedation anesthesia. You will be sleeping during the entire procedure.
During the procedure, the surgeon will make an incision on the top of your toe to access the bone and joint structures that have been affected by the hammertoe. A portion of bone from the joint will be removed to reduce toe contracture.
Finally, your surgeon will insert a K-wire into the toe bones to splint the toe to keep it straight while it is healing.
Recovery After Arthroplasty Hammertoe Surgery- What to Expect
You will need to remain weight-bearing in a post-operative shoe for 4 weeks after the procedure. Sutures will be removed 2 weeks after the procedure.
The K-wire will be removed (in the office) 4 weeks after the procedure. Removing the K-wire is not painful and you don’t need anesthesia for this. Afterward, you can transition into athletic shoes.
The primary benefit of arthroplasty hammertoe surgery is pain relief. Hammertoe surgery is effective in reducing contracture of the toe and relieving pressure from the top of the toe and tip of the toe. If you have an ulcer or painful corn on the top of your toe, an arthroplasty can provide significant relief.
Arthrodesis Hammertoe Surgery
Arthrodesis hammertoe surgery is a type of reconstructive foot surgery that involves the fusion of the affected toe’s joint to correct its position and reduce pain. In most cases, an implant would be used to stabilize the fusion site. Implants can stay in the toe forever and do not need to be removed unless they break.
The procedure is typically performed under sedation anesthesia. You will be sleeping during the entire procedure. You can be discharged home after the procedure.
The benefit of the arthrodesis procedure is that it works well to straighten severe hammertoe contractures and helps rebalance the joints. This procedure works especially well if you have multiple toes that need to be repaired. By realigning and fusing your toes, you can expect improved mobility as well as improved balance when walking or standing on uneven surfaces.
Recovery After Arthrodesis Hammertoe Surgery- What to Expect
You will need to remain weight-bearing in a post-operative shoe for 4-6 weeks after the procedure. Sutures will be removed 2 weeks after the procedure. You will follow up with your doctor every 3 weeks. Your doctor will order x-rays during your visits to ensure that the fusion site is healing. After 4-6 weeks, your doctor will allow you to transition into athletic shoes.
Complications of Hammertoe Surgery
Although most people don’t experience major complications after undergoing hammertoe surgery, some complications can occur.
Some complications include:
Infection: Like with any surgery, infections can occur after undergoing hammertoe surgery. If you develop redness, heat at the surgical site, and pain, notify your doctor immediately. You may need antibiotics. There is also a chance that the implant may become infected. Stronger antibiotics may be needed in this case. In some cases, the hardware may need to be removed.
Nerve injury: Occasionally, nerve injury can occur during surgery. This may be temporary or permanent. You may experience burning, tingling, or numbness in the toe.
Hardware complications: Occasionally, hardware that is placed into the toe can break/bend. The risk is higher if you fall or bump your toes after surgery. In this case, your doctor may need to perform another surgery to fix the toe with new hardware.
Recurrence of hammertoe: In many cases, hammertoes can recur. This can occur due to tight tendons in the foot and if you wear ill-fitting shoes after surgery. Improper shoes, especially constricting shoes, can cause your toes to bend and hammertoes to recur.
Do Hammertoes Get Worse With Age?
Hammertoes can worsen with age because the muscles around your toes weaken making it difficult for them to maintain their normal position even when wearing proper footwear with good arch support. This makes it more likely that your toe will stay bent into its abnormal position causing additional discomfort and difficulty walking over time.
How Soon Can I Drive After Hammertoe Surgery?
If the hammertoe surgery was done on the right foot, then you should wait 4-6 weeks before driving. It is not safe to drive with a post-op shoe on. Not only that, premature driving can disrupt the surgical site. If the hammertoe surgery was done on your left foot, you can start driving 1-2 weeks after surgery. Make sure to avoid driving while taking narcotic pain medications.
Can You Wear Socks After Hammertoe Surgery?
You should avoid wearing tight-fitted socks for a month after hammertoe surgery. This is because constricting socks can apply unnecessary pressure on the toes and can cause problems with healing. Also, some people have a K-wire present splinting the toe. Socks can get caught on the wire, causing the wire to pull out. If you must keep your toes covered, use a loose-fitting sock or stockinette dressing to keep the toes covered.
Do You Have to Use Crutches With After Hammertoe Surgery?
Although crutches are not generally necessary after hammertoe surgery, they can help with balance while walking after surgery. After hammertoe surgery, it’s generally recommended that you walk on your heel and avoid putting pressure on your toes. Crutches can be a helpful aid to achieve this.
When Can I Shower After Hammertoe Surgery?
You can shower the same day after the surgery. Make sure you keep your foot dressing dry using a cast protector. You will need to keep your dressing dry for the first 10 days after surgery.
Can a Podiatrist Fix a Hammertoe?
Podiatrists are foot and ankle surgeons that can fix hammertoe deformities. Make sure you visit your local Board-Certified Podiatrist for recommendations regarding surgery if you experience pain from your hammertoes.
Do You Need Physical Therapy After Hammertoe Surgery?
Generally, physical therapy is not needed after hammertoe repair. However, if you are struggling with balance issues after surgery, physical therapy can be beneficial in regaining strength in the leg/foot and improving balance. Your doctor may recommend you complete physical therapy 3 times a week for 1 month.
Related article: Hammertoes: Causes, Symptoms, Diagnosis & Treatment of a Hammertoe
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