Hammer toe is a condition that affects one of the three middle toes, causing the toe to bend upward at its middle joint. Some people can manage symptoms from this condition with lifestyle changes. If lifestyle changes don’t help reduce your pain, surgery may be a solution to this foot condition.
Keep reading to learn more about hammer toe surgery.
Who is a good candidate for surgery?
Surgery shouldn’t be a first option for hammer toe treatment. You may be able to reduce or eliminate your pain by wearing bigger shoes or using shoe inserts or pads. Exercises to stretch and strengthen your toe, such as scrunching up a towel with your toes, may help in some cases.
If those methods don’t relieve your pain, surgery may be a good option for you.
You should avoid hammer toe surgery if you have:
- poor circulation in your feet
- an active infection
- health problems that would make surgery risky
Foot surgery may be possible when other health conditions improve.
What to expect during surgery
Hammer toe surgery is usually done as an outpatient procedure. That means you can go home the same day you have the surgery. You may receive general anesthesia so you’re asleep for the entire procedure. Your doctor may decide to do the surgery without general anesthesia, and instead use numbing medications so that you can’t feel any of the work being done on your foot. Discuss these options with your doctor.
The type of procedure you have will depend on the severity of your hammer toe. If the toe is still somewhat flexible, the surgeon may be able to do a tendon transfer. This involves redirecting tendons from the bottom of the toe to the top where it’s bent. The rerouted tendons can then help straighten the toe.
If your hammer toe has become fixed or stiff, the surgeon has two options: joint resection or fusion.
In joint resection, an incision is made on the top part of the toe to reach the ligaments and tendons underneath. The ligaments and tendons may be cut to help straighten the toe. The end of one bone is taken off so that the toe can be fully extended. Small metal pins or rods are often used to keep the toe straight during healing. The pins are usually removed a month or so after surgery.
With fusion, ligaments and tendons are also cut to straighten the toe. In this procedure, however, the ends of the two bones that form the affected joint are cut to make the toe straight. Pins or screws are used while the ends of the bone heal or fuse together.
Hammer toe is usually covered by insurance or Medicare if the condition is deemed medically necessary. Your doctor may consider the surgery medically necessary if:
- you’re experiencing pain
- the hammer toe is affecting your balance
- the hammer toe is affecting your general foot health
Correcting a hammer toe for purely cosmetic reasons isn’t likely to be covered by insurance.
The out-of-pocket cost for hammer toe surgery is about $4,265, according to the Healthcare Bluebook.
Full recovery from hammer toe surgery may take a few weeks. The timetable will be determined by the type of surgery. You may get a special shoe to help you with walk and maintain your balance during your recovery. You may also need crutches or a walker.
You should try to keep your foot elevated most of the time in the first couple of weeks after surgery. This will take pressure off the toe and allow it to heal. You can expect some swelling around the toe. Swelling could last up to a year, but the pain should subside fairly soon after the operation. If you have pins or screws in your toe, they may be taken out a few weeks after the operation.
If the operation was on your right foot, you will have to avoid driving for a few weeks. Be sure to ask your doctor about any restrictions on driving or other activities. You also shouldn’t place your foot under water until the pins or screws are removed.
All surgeries have risk of complications, including:
- nerve damage
- blood clot formation
- a bad reaction to the anesthesia, if used during your surgery
Complications specific to hammer toe surgery include the possibility that your toe could eventually curl up again. This is unusual, however. It’s also rare that the bones don’t heal properly after a fusion procedure.
If your hammer toe returns, which is unlikely, a second surgery may be necessary. What’s more common is that you may only be able to bend your toe slightly. Some people are unable to bend their toe at all. This shouldn’t affect your walking or balance.
You will probably have to avoid shoes that squeeze your toes and high heels that put pressure on the toes. Hammer toe surgery should relieve the pain, discomfort, and cosmetic concerns.
In order to prepare for your surgery, here a few things to do:
- Line up a ride home after the procedure.
- Consider arranging for a caregiver to help you the day of the surgery, and possibly for one or two days afterward.
- If you have a two-story home, set up an area with everything you’ll need downstairs so you can avoid stairs while you recover.
If you’re still at the early stages of discussing your treatment options, ask your doctor about which type of surgery will be best for you and why. Make sure you understand the risks and benefits of each option, and how you can have a healthy recovery.