Hammertoe surgery is performed when crooked or contracted toes become painful, or contribute to painful corns or wounds. Although the surgeons here do not perform cosmetic surgery, correction of a non-painful hammertoe can be performed to maintain the cosmetic appearance of a foot in which other adjacent hammertoes are being corrected, or if future problems are anticipated. The procedure can involve multiple steps, and there are couple basic procedures that are performed. The most common procedure performed is called an arthroplasty. In this procedure, part of the bone is removed where the toe is most contracted, in order for the toe to flatten out again. The toe is typically held in a straight position during the healing process by a temporary external wire or an internal pin, although the little toe is usually not secured in this manner. Other steps that are often performed at the same time to help the toe relax fully include moving or lengthening one of the toe tendons, releasing a tissue at the base of the toe, or even moving back a bone behind the base of the toe. Another common procedure that is performed on rigid toe deformities or toes that are difficult to keep straight is a fusion procedure in which the bone is not removed, but the joint ends are fused together to lock the toe in a straight position. This fusion is held in place with an external wire or internal pin for 5-6 weeks until the bone has healed and the joint is fully fused.
Recovery from hammertoe surgery is usually rapid compared to other bone procedures. A hard-soled post-operative shoe is worn until the wires are removed or until a fusion has healed. Activity is generally limited, but weight bearing is almost always allowed, and pain is limited and controlled with moderate strength pain medications, as well as icing and elevation. Elevation of the foot and rest is absolutely necessary the first week following surgery, as excess activity can lead to lengthy swelling of the toe and temporary pain. Complications are generally low in otherwise healthy patients. Most patients who have an arthroplasty performed are back in a regular shoe within four weeks, while those who have a fusion performed wait one or two weeks more.