Hammertoe Repair

What is a hammertoe repair?

A hammertoe repair is a surgical procedure for a misshapen toe. When you have a hammertoe, the middle joint of the toe bends up in a way that makes the toe look like it is forming an upside-down V. The bent joint may rub the top of your shoe. Hammertoes can develop on any toe, but they usually happen in the second toe. The repair is done by fusing, removing, or realigning the bones.

When is it used?

Reasons for doing this procedure are:

• The shape and position of your toe cause pain.
• One or more of the bones in your toe have become deformed. This may make it difficult or painful to walk. It may be hard to find shoes that are comfortable.

An example of an alternative is to choose to do nothing, recognizing the risks of your condition. You should ask your healthcare provider about your choices.

How do I prepare for this procedure?

Plan for your care and recovery after the operation. Find someone to drive you home after the procedure. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow your provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.

If you need a minor pain reliever in the week before the procedure, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before the procedure.

Follow any other instructions provided by your healthcare provider. No special preparation is usually needed.

What happens during the procedure?

You may be given a local or regional anesthetic. Either type of anesthesia should keep you from feeling pain during the operation.

The type of surgery you have depends on how misshapen and inflexible the toe is. The surgeon may make a cut over your toe and release the tendon by cutting it away from the bone. Or the surgeon may remove a small piece of bone from the toe. The surgeon may realign the tendons to reposition your toe or fasten the bones with pins. In severe cases the surgeon may use a pin to hold the toe in place or join (fuse) the bones in the toe. If the bones are fused together, you will no longer be able to bend the toe, but the toe will be flat.

What happens after the procedure?

You can usually go home from the hospital the same day you have the operation. A dressing will be on your toe to keep it in its new position.

The toe may be quite swollen for a while after the surgery. For the first several weeks you will need to try to stay off the foot as much as possible. Your healthcare provider may want you to use crutches or a special shoe after surgery. You will need several weeks of recovery if bones in the toe were fused.

Ask your provider what steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

• The deformed toe is in a better position than before the operation.
• You will have less pain in your toe.
• It is easier to find shoes that fit.

What are the risks associated with this procedure?

• A local or regional anesthetic may not numb the area quite enough and you may feel some minor discomfort during the surgery. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia.
• The bones could go back to a painful or awkward position again.
• You may have infection or bleeding.
• The nerves or arteries in the area may be damaged.
• The toe may be swollen after surgery for several months.

You should ask your healthcare provider how these risks apply to you.

When should I call my healthcare provider?

Call your provider right away if:

• You are in a lot of pain.
• You have a lot of swelling around the toe.
• You develop a fever.
• You have a lot of bleeding.
• You have any signs of infection, such as: pus or drainage, redness around the site, warmth, or weakness.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.