A hammertoe is a deformity in which one or more of the smaller toes bend downward at the middle joint, creating a hammer-like appearance. The second toe is most commonly affected, but the third and fourth toes can also develop this problem.
Hammertoe develops when the muscles and tendons that control toe movement become unbalanced. Over time, the toe may become stiff and permanently bent. This can cause pain, rubbing against shoes, and painful corns or calluses.
When shoe changes, padding, and other non-surgical treatments no longer provide relief, surgery may be recommended to straighten the toe and reduce discomfort.
Causes and Symptoms
Hammertoes can develop from wearing shoes that are too narrow or short, frequent use of high heels, previous toe injuries, or abnormalities in foot structure.
Flatfoot, arthritis, and certain neurological conditions can also contribute.
Common symptoms include a visibly bent toe, pain when walking or wearing shoes, and irritation where the toe rubs against footwear. Corns or calluses may form over the top of the bent joint or at the tip of the toe. In more advanced cases, the toe becomes rigid, swollen, and increasingly painful.
Diagnosis and Evaluation
Your doctor will examine the foot and assess the toe’s alignment and flexibility. They will also look for corns, calluses, swelling, and other deformities that may be contributing to the problem.
X-rays may be taken to evaluate the position of the bones and joints and check for arthritis, bone spurs, or joint damage. This helps determine how severe the deformity is and which treatment is most appropriate.
Hammertoes are generally described as flexible or rigid. A flexible toe can still be straightened manually and may respond to non-surgical treatment. A rigid hammertoe is fixed in position and is more likely to require surgery.
Non-Surgical Treatment
Early or flexible hammertoes can often be managed without surgery. Treatment may include wearing shoes with a wide toe box, using padding to protect areas that rub against footwear, and wearing custom orthotics to redistribute pressure.
Toe splints and stretching exercises may also help reduce discomfort and improve flexibility. Anti-inflammatory medication may be considered when appropriate.
These treatments can relieve symptoms, but they cannot reliably straighten a rigid or fixed deformity.
Hammertoe Surgery
Surgery is generally considered when the toe remains painful or makes it difficult to walk or wear shoes despite non-surgical treatment. The two common procedures are PIP joint resection arthroplasty and PIP joint fusion.
Joint Resection Arthroplasty
In this procedure, the surgeon removes a small portion of bone from the middle joint of the toe to allow it to straighten and reduce pressure. This approach may be appropriate for certain deformities where preserving some movement is preferred.
Joint Fusion
For a more rigid deformity or a joint with significant damage, the surgeon may recommend fusion. The damaged cartilage is removed from the joint, and the bones are positioned in a straighter alignment. They are held together with a temporary pin, screw, or internal implant while the bones heal.
Both procedures typically involve a small incision over the toe and may require releasing tight tendons or ligaments to achieve proper alignment. Your surgeon will recommend the procedure based on the severity of the deformity and the condition of the joint.
Recovery After Surgery
After surgery, the foot is protected with a dressing and a special postoperative shoe. Many patients can begin walking on their heel within a few days, depending on the procedure and the surgeon’s instructions.
If a temporary metal pin is used, it is generally removed after three to six weeks. Stitches are usually removed around two weeks after surgery. As healing progresses, you will gradually increase activity and transition back to regular footwear.
Most patients recover over several weeks, with many returning to normal activities within six to eight weeks. Swelling and stiffness can last longer, and some patients may benefit from exercises or physical therapy to restore strength and movement.
Risks and Possible Complications
As with any surgery, hammertoe correction has potential risks. These include infection, delayed wound healing, swelling, stiffness, numbness, and recurrence of the deformity.
Some patients may continue to experience pain or develop a slightly shorter toe, particularly after resection arthroplasty. Hardware can also cause irritation and may require removal.
Your surgeon will discuss the risks and expected results based on your specific condition and the procedure being performed.
Long-Term Outlook
Hammertoe surgery can provide lasting improvement in toe alignment and pain when the procedure is appropriately selected. Most patients are able to wear regular shoes more comfortably and return to their usual activities.
The deformity can return in some cases, particularly when it is severe or other foot problems are not addressed. Wearing properly fitted shoes and following your surgeon’s recovery instructions can help protect the results.
When to See a Specialist
Consider seeing a foot and ankle specialist if you have a painful or stiff toe, recurring corns or calluses, or difficulty wearing shoes or walking because of the deformity. Early evaluation can help determine whether non-surgical treatment is appropriate or whether surgery may be needed.
After surgery, seek prompt medical attention if you develop severe or worsening pain, significant bleeding, increasing redness, swelling, or drainage.
Insurance and Cost
Hammertoe surgery at Complete Orthopedics is covered by Medicare and most major commercial insurance carriers, including Aetna, Anthem BCBS, Cigna, Empire BCBS, and UnitedHealthcare, as well as most workers’ compensation and no-fault insurance carriers. Your out-of-pocket cost depends on your specific plan, deductible, and medical necessity requirements.
Call our billing team at (631) 981-2663 before scheduling to verify your coverage and discuss expected out-of-pocket costs.
For a full list of accepted insurance plans, visit our Insurance Information page.
The content on this page has been authored, edited, or approved by the doctors below, and was last reviewed for accuracy on November 12, 2026.
