When Does Hammertoe Require Surgery?

When treating hammertoe at Achilles Foot Care, our top concern is relieving your pain and restoring normal movement so you can stay active and healthy. With early treatment, we can usually do that without surgery.

If your hammertoe goes untreated, however, it progressively worsens. Eventually, it reaches a stage where surgery is required.

Hammertoe info

Hammertoe is a deformity that can develop in your second, third, and fourth toes. The problem begins when the middle joint in the toe bends abnormally, making the tip of your toe turn downward rather than point straight out. As a result, the toe resembles the shape of a hammer.

As your toe is forced to stay in a bent position, the muscles responsible for bending your toe begin to shorten and tighten. Ultimately, they become so tight that you can’t straighten your toe.

Underlying cause

Improperly fitting shoes are the primary cause of hammertoe. Narrow-toed shoes can squish your toes into a bent position. High heels cause a similar problem, as they force your toes against the front of the shoe.

When shoes constrict and bend your toes over an extended time, the muscles shorten to accommodate the position.  

You’re more likely to develop a hammertoe if you have an inflammatory joint disease like arthritis. Bunions also raise your risk because they push your big toe into your second toe, which may in turn force your second toe into a downward, hammertoe position.

Pain and other symptoms

Not being able to straighten your toe is the obvious symptom, but hammertoe is also painful, affecting the top or the base of your bent toe. You may also experience pain in the ball of your foot and when you move your toe.

As the top of the bent toe rubs against your shoe, a painful corn often develops. Patients with hammertoes also tend to develop calluses, which contribute to foot discomfort.

When hammertoe requires surgery

Treatment decisions are based on the severity of your hammertoe. When the deformity first develops, your affected toe still has some flexibility. At this stage, conservative treatments may effectively relieve pain and restore your toe’s normal position and functioning.

Without treatment, however, hammertoe worsens. The muscles and tendons stay tight, and the toe becomes rigid and fixed in its bent position. Now the toe is in a state of permanent contracture.

Once your hammertoe is rigid, surgery is the only way to fix the problem and relieve your pain.

Non-surgical treatment options at an early stage

While your toe is still flexible, Dr. Patrick D. Roberto can treat the problem with a variety of conservative options. A few examples include:

If you still have pain and limited motion despite conservative treatment, your toe is severely deformed, or contracture has settled in, you need surgery to restore function and eliminate your pain.

Different types of hammertoe surgery

When you decide it’s time for surgery, you can count on Dr. Roberto’s surgical skill and extensive experience performing several types of hammertoe surgery. The type of surgery that’s best for you depends on whether your hammertoe is flexible or rigid.

Flexible hammertoe

Even when your toe is still flexible, it’s possible to have enough pain and difficulty moving to consider surgical intervention.

The most common surgery for flexible hammertoe is straightening the toe with a tendon transfer. This procedure involves rerouting tendons to maneuver the bent joint back into a straight position.

Rigid Hammertoe

In this case, Dr. Roberto may recommend a joint resection or a bone fusion. During a joint resection, part of your bone is removed to allow your toe to return to its normal position. In a fusion, the toe is straightened and then the bones are fused together, which prevents the toe from bending.

Hammertoe surgery is usually an outpatient procedure, so you go home the same day. Full recovery can take weeks, however, depending on the type of surgery. Right after surgery, you need to keep your foot elevated, so you should plan for downtime.

At Achilles Foot Care, you can count on expert treatment whether your hammertoe can be treated with conservative therapies or requires surgery. If you have questions about hammertoe, call either our Delmont or Monroeville office, or book an appointment online.

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