A hammertoe is a deformity of the second, third, or fourth toes. In this condition, the toe is bent at the middle joint, causing it to resemble a hammer. Left untreated, hammertoes can become inflexible and painful, requiring surgery. Even if they are flexible they can cause enough pain to warrant surgery.
Hammertoe surgery can be done on an outpatient basis in the doctor's office (under local anesthesia) or in an ambulatory surgical center (using a local anesthetic combined with IV sedation).
The surgery takes about 15 minutes to perform. Depending upon whether the hammertoe is rigid or flexible, different procedures are indicated. If the toe is flexible, we can get away with cutting some ligaments and tendons (which WILL reattach after a while). If the toe is rigid, a piece of bone has to be removed from one of the joints. Patients usually can walk immediately after the surgery wearing a special surgical shoe, although the more they can stay off the foot for a few days, the better off they will be. Will there be pain? Yes, but we give prescriptions for pain medications, so this is generally not a problem for the patient.
Icing and elevation of the foot is recommended during the first week following the procedure to prevent excessive swelling and promote healing. It is also important that the dressing be kept clean and dry to prevent infection. Two weeks after the surgery, the sutures are removed and a wide athletic shoe can replace the post-operative surgical shoe. Patients can then gradually increase their walking and other physical activities.
