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Hammer toe repair

Definition

A hammer toe is a toe that stays in a curled or flexed position. It can be caused by a muscle imbalance, arthritis, or shoes that do not fit well.      

Hammer toe can occur in more than one toe.

Alternative Names

Flexion contracture of the toe

Description

Several different kinds of surgery can repair hammer toe. Your bone or foot doctor will recommend the kind that will work best for you. Some of the surgeries include:

  • Remove parts of the toe bones.
  • Cut or transplant the tendons of the toes (tendons connect bone to muscle).
  • Fuse the joint together to make the toe straight and no longer able to bend. 

After surgery, you may have surgical pins or a wire (Kirschner, or K-wire) to hold the toe bones in place while your toe heals.

Why the Procedure Is Performed

When hammer toe is starting to develop, you may still be able to straighten yourtoe. Over time, your toe may get stuck in a bent position and you can no longer straighten it. When this happens, painful, hard corns (thick, callused skin) can build up on the top and bottom of your toe and rub against your shoe. 

Hammer toe surgery is not done just to make your toe look better. Consider surgery if your hammer toe is stuck in a flexed position and is causing:

  • Pain
  • Irritation·
  • Sores

Skininfections 

Surgery may not beadvised if:

  • Treatment with paddings and strapping works
  • You can still straighten your toe
  • Changing to different shoe types can alleviatesymptoms

Risks

Risks of hammer toe surgery are:

  • Poor alignment of the toe
  • Allergic reactions to medicines you receive before or during surgery
  • Bleeding
  • Infection in the bones of the toe
  • Injury to nerves that could cause numbness in your toe
  • Scar from surgery that hurts when it is touched
  • Stiffness in the toe or a toe that is too straight

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

  • You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen, (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
  • Ask your doctor which drugs you should still take on the day of your surgery.
  • If you smoke, try to stop. Ask your doctor or nurse for help. Smoking can slow healing.
  • Always let your doctor know about any cold, flu, fever, or other illness you may have before your surgery.
  • You will usually be asked not to drink or eat anything for 6 - 12 hours before surgery.

If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see your doctor who treats you for these conditions.

After the Procedure

Most people go home the same day they have hammer toe surgery. Your doctor or nurse will tell you how to take care of yourself at home after surgery.

References

Ishikawa SN, Murphy GC. Lesser toe abnormalities In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 80.


Review Date: 7/14/2012
Reviewed By: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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