How Do I Treat a Hammertoe?

You’ve noticed your toes are curling, and now you are developing pain. You’ve tried different shoes, but the pain is worsening. What should you do?

If a curling  toe is painless, then it doesn’t need treatment at all, as the purpose of treatment is to minimize pain and improve function. But if a hammertoe is causing pain, then there are both nonoperative and surgical treatments. 

What are nonoperative treatments for hammertoes?

There are many nonoperative treatments for hammertoes. The initial treatment is to find properly fitted shoes with a wide and high toe box.

A Budin splint is a low-profile splint with a loop that goes around the hammertoe to hold it straight. This can help with the symptoms of a hammertoe, but it cannot fix the deformity. 

Physical therapy and home exercises can be used for hammertoes as well. We call toe exercises ‘toe yoga’ or ‘toga.’

Can hammertoes be fixed without surgery?  

In short, no, but that doesn’t mean every hammertoe needs surgery. If nonoperative treatments can control the pain associated with a hammertoe, surgery is not needed.

Which doctor evaluates hammertoes?

The orthopedic surgeons at Southwest Orthopedic Group can diagnose and treat your hammertoes. They use a thorough physical exam and x-rays to evaluate your toes. 

Will hammertoes go away?

A hammer toe will not go away on its own. The deformity may be stable or it may get worse. 

How is hammertoe surgery done?

There are different types of hammer toe surgery, depending on the type of forefoot deformity you have. 

If the hammertoe is flexible, meaning you can use your finger to straighten it out, your orthopedic surgeon may offer you a procedure to reroute a tendon to correct the deformity. This allows your toe to have some flexibility at the PIP joint. This procedure can have some recurrence of your hammertoe, but this is rare. 

If the hammertoe is rigid, meaning you can’t use your finger to straighten it out, a toe fusion is recommended. During this surgery, the joint is cut out and a few millimeters of bone around the joint is removed. This allows your surgeon to straighten your toe. After this, it is typically pinned in place with a wire. This wire can be removed in clinic in approximately 6 weeks. 

If there are other hammer toes or forefoot deformities (like a bunion), these can be corrected at the same time. The ultimate goal of the surgery is to straighten the toes and decrease pain in the forefoot. 

Can I walk after hammertoe surgery?

Yes! But with bandages and an orthopedic shoe. Immediately after surgery, the toes are wrapped in sterile dressings. Most patients are able to walk, but they put most of their weight on their heel or midfoot in the orthopedic shoes. A patient can transition back into normal shoes at approximately 6 weeks after hammertoe surgery, but this may be longer if other procedures are done. 

Why is there still swelling in my toe after surgery?

Unfortunately, swelling in the toes persists longer than patients prefer after hammertoe surgery. 

The American Orthopaedic Foot & Ankle Society (AOFAS) has more information about ankle fractures at FootCareMD.

For more questions or to set up an evaluation, contact Dr. Stautberg’s office at 281-977-4870. 

Author

Eugene Stautberg, MD