Flexion contracture of the toe
A hammer toe is a toe that stays in a curled or flexed position.
This can occur in more than one toe.
This condition is caused by:
- Muscle imbalance
- Rheumatoid arthritis
- Shoes that do not fit well
Several 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:
- Removing parts of the toe bones
- Cutting or transplanting the tendons of the toes (tendons connect bone to muscle)
- Fusing the joint together to make the toe straight and no longer able to bend
After surgery, surgical pins or a wire (Kirschner, or K-wire) are used to hold the toe bones in place while your toe heals. You will be asked to use a different shoe to walk to allow your toes to heal. The pins will be removed in a few weeks.
Why the Procedure Is Performed
When hammer toe starts to develop, you may still be able to straighten your toe. 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:
- Problems finding shoes that fit
- Skin infections
Surgery may not be advised if:
- Treatment with paddings and strapping works
- You can still straighten your toe
- Changing to different shoe types can alleviate symptoms
Risks of anesthesia and surgery in general are:
- Reactions to medicines
- Breathing problems
Risks of hammer toe surgery are:
- Poor alignment 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
- Shortening of the toe
- Loss of blood supply to the toe
Before the Procedure
Always tell your health care provider what medicines you are taking, even medicines, supplements, or herbs you bought without a prescription.
- You may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen, (Advil, Motrin), naproxen (Naprosyn, Aleve), and other drugs.
- Ask your provider which medicines you should still take on the day of your surgery.
- If you smoke, try to stop. Ask your provider for help. Smoking can slow healing.
- Always let your provider know about any cold, flu, fever, or other illness you may have before your surgery.
- You may be asked not to drink or eat anything for 6 to 12 hours before surgery.
If you have diabetes, heart disease, or other medical conditions, your surgeon will ask you to see the provider who treats you for these conditions.
After the Procedure
Coughlin MJ. Lesser toe deformities. In: Coughlin MJ, Saltzman CL, Anderson RB, eds. Mann's Surgery of the Foot and Ankle. 9th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 7.
Murphy GA. Lesser toe abnormalities. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 83.
Price MD, Chiodo CP. Foot and ankle pain. In: Firestein GS, Budd RC, Gabriel SE, O'Dell JR, eds. Kelley and Firestein's Textbook of Rheumatology. 10th ed. Philadelphia, PA: Elsevier; 2017:chap 49.
Winell JJ, Davidson RS. The foot and toes. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 674.