If one of your toes has gradually curled into a bent position and no longer straightens on its own, you may have a hammertoe. In mild cases, footwear changes and padding can help manage symptoms. However, when the toe becomes rigid, painful, or interferes with daily activity, surgery may be discussed as an option. A chiropodist can assess the severity of the deformity and help determine whether conservative care or a surgical approach such as tendon release is more appropriate.

Hammertoe surgery refers to a group of procedures used to correct a toe deformity where the middle joint bends abnormally. The specific procedure depends on whether the toe is still flexible or has become rigid. In Ontario, chiropodists perform soft tissue procedures including tendon release as part of their authorized scope of practice. More complex bone procedures may require referral to a podiatric surgeon or orthopedic specialist.

Hammertoe
A hammertoe is a deformity of the second, third, or fourth toe where the middle joint bends upward, causing the toe to curl downward. It develops from an imbalance between the muscles and tendons that control toe movement. Over time, the joint can stiffen and the toe may become fixed in a bent position.

Flexible vs. Rigid Deformity
A flexible hammertoe can still be straightened by hand and often responds to conservative treatment. A rigid hammertoe can no longer be moved into a straight position manually. This distinction is important because it determines which treatment approaches are most appropriate.

When Does a Hammertoe Need Surgery?

A hammertoe may need surgery when the toe has become rigid and can no longer be straightened manually, when pain persists despite footwear changes and conservative treatment, or when the deformity causes secondary problems like corns, calluses, or difficulty wearing shoes.

Surgery is not the first step in treating a hammertoe. A chiropodist will typically begin with conservative measures and recommend surgery only when those options have not provided adequate relief or when the deformity has progressed beyond what non-surgical care can address.

Can a Hammertoe Be Fixed Without Surgery?

In many cases, yes. Before considering surgery, most patients will have tried several non-surgical approaches. These may include switching to shoes with a wider and deeper toe box, using protective pads to reduce friction, toe exercises to maintain flexibility, and custom orthotics to redistribute pressure across the foot. According to the American Academy of Orthopaedic Surgeons, conservative treatment is the standard first approach for flexible hammertoes. Surgery is usually discussed only after these measures have been given adequate time and the patient continues to experience pain or functional limitations.

What Happens When a Hammertoe Becomes Rigid?

When a hammertoe becomes rigid, the joint locks into a bent position and can no longer be straightened by hand. At this stage, stretching, taping, and orthotics typically cannot correct the deformity. The rigid toe often develops painful corns on top from shoe friction, and walking mechanics may change as the foot compensates for the misaligned joint.

This distinction between flexible and rigid is one of the most important factors in treatment planning. If the rigid deformity causes ongoing pain, difficulty wearing shoes, or secondary problems, the chiropodist may discuss surgical options.

What Are the Different Types of Hammertoe Surgery?

There are several types of hammertoe surgery. The procedure recommended depends on the severity and flexibility of the deformity.

Tendon release or transfer involves repositioning or lengthening the tendons that pull the toe into a bent position. This is most commonly used for flexible hammertoes. The goal is to restore balance between the tendons so the toe can straighten.

Joint resection, also called arthroplasty, involves removing a small portion of bone from the affected joint to allow the toe to straighten. Temporary pins may be placed to hold the toe in position during healing.

Joint fusion, also called arthrodesis, involves removing the ends of bone at the joint and allowing them to heal together in a straight position. This is typically used for rigid deformities and provides a stable correction.

Most hammertoe surgeries are performed on an outpatient basis using local anesthesia. The procedure usually takes under an hour.

Can a Chiropodist in Ontario Perform Hammertoe Surgery?

Yes. In Ontario, chiropodists are authorized to perform soft tissue surgical procedures, including tendon release, under the Chiropody Act, 1991. This means that certain hammertoe procedures can be performed in a chiropody clinic without a hospital visit.

For procedures that involve bone, such as joint resection or fusion, the chiropodist may refer the patient to a podiatric surgeon or orthopedic specialist. The chiropodist’s role in these cases includes the initial assessment, identifying the type and severity of the deformity, discussing the options with the patient, and coordinating referrals when needed.

Recovery from hammertoe surgery varies depending on the procedure. Patients generally wear a protective surgical shoe for three to six weeks after the procedure. Stitches are typically removed around two weeks after surgery. If pins are used, they are usually removed within three to six weeks. Swelling may persist for several weeks, and full recovery, including return to regular footwear and activities, often takes six to twelve weeks. The chiropodist or surgeon will provide individualized aftercare instructions based on the procedure performed.

It is important to follow post-operative care instructions carefully. Keeping the foot elevated, protecting the surgical site, and attending follow-up appointments all contribute to the healing process.

What Causes Hammertoes in Cambridge, Ontario?

Hammertoe deformities are common in Cambridge and across Ontario. Factors such as wearing narrow or ill-fitting shoes, having a longer second toe, and conditions like arthritis or diabetes can increase the risk of developing a hammertoe. Patients who notice a toe beginning to curl or who develop corns on the top of a toe should consider having the foot assessed before the deformity progresses.

Common Questions About Hammertoe Surgery and Recovery

How long does it take to recover from hammertoe surgery?

Recovery depends on the type of procedure. Most patients can walk in a protective shoe within a few days. Full recovery, including a return to normal footwear and activities, generally takes six to twelve weeks.

Will a hammertoe come back after surgery?

Recurrence is uncommon but possible, particularly if the factors that contributed to the original deformity are not addressed. Wearing supportive shoes and using orthotics after surgery can help reduce the risk of recurrence.

Does hammertoe surgery hurt?

The procedure is performed under local anesthesia, so you should not feel pain during surgery. Some discomfort and swelling are common during the first few days of recovery. Most patients manage this with over-the-counter pain relief and elevation.

For those exploring alternatives to surgery, you can learn more about non-surgical hammertoe treatment options and when they may be appropriate.

If you experience sudden increase in pain, warmth, redness, or swelling at the surgical site, or signs of infection such as discharge, contact your healthcare provider promptly.

Reviewed by Patricia Wilson, BScN, RN, DCh, a registered chiropodist in Ontario. This information is for educational purposes and does not replace an in-person assessment by a qualified foot care professional.

If you have a hammertoe that is causing pain or limiting your activity, consider booking an assessment. Contact our clinic to discuss your condition and learn about the treatment options available to you.