Hammertoe Surgery: What to Expect Before, During, and After

A hammertoe develops when one of the smaller toes — usually the second, third, or fourth — bends abnormally at the middle joint, creating a raised, claw-like shape. It's more than cosmetic. That raised joint rubs against shoes, forming painful corns and calluses. The toe can become rigid over time, and the imbalance can spread, affecting neighboring toes and how your forefoot handles pressure.

If your hammertoe is still flexible (you can manually straighten it), conservative treatment — wider shoes, padding, toe exercises, and orthotics — may keep it manageable for years. But once the joint becomes rigid and painful, or it's altering how you walk, surgical correction becomes the most reliable path to lasting relief.

Before Surgery

Hammertoe correction is an outpatient procedure done under local anesthesia with sedation, or sometimes with just a local block similar to what we use for ingrown toenail procedures. We'll take X-rays to evaluate the bone alignment and joint condition, discuss the specific technique best suited to your toe, and review what your recovery will look like.

There's no overnight hospital stay. You'll arrive, have the procedure, and go home the same day. Make sure you have someone to drive you home and wear loose, open-toed footwear to the appointment.

During the Procedure

Our approach to hammertoe correction is minimally invasive, which makes a significant difference in both the procedure itself and your recovery. Here's what that means in practice:

Instead of a large incision along the top of the toe, we use one or two tiny incisions (a few millimeters each). Specialized instruments are guided by real-time X-ray imaging to precisely remove the small section of bone causing the joint contracture. The toe is then realigned and held in its corrected position, typically with a small pin or internal device.

The entire procedure takes approximately 15–30 minutes per toe. Because the surrounding soft tissue is minimally disrupted, there's less post-operative swelling, less pain, and a faster return to normal footwear compared to traditional open techniques.

After Surgery: The First Week

You'll leave the office in a surgical shoe — a rigid, flat-bottomed shoe that keeps pressure off the forefoot. You can walk on the heel immediately, though most patients prefer to limit walking for the first few days.

Expect moderate swelling and mild to moderate discomfort for the first 3–5 days. Elevating your foot above heart level and icing around (not directly on) the surgical site helps considerably. Most patients manage pain adequately with over-the-counter medication; stronger pain relief is available but rarely needed beyond the first day or two.

We'll see you for a follow-up visit within the first week to check the surgical site, change dressings, and confirm everything is healing on track.

Weeks 2–6: Getting Back to Normal

Swelling gradually decreases. The surgical shoe is typically needed for 3–4 weeks total. If a temporary pin was placed, it's usually removed at 3–4 weeks — this is quick and well-tolerated. By 4–6 weeks, most patients are transitioning back into regular shoes, starting with roomier, supportive options.

Full healing and final toe position take about 2–3 months. The toe may appear slightly swollen for several weeks after you've returned to normal shoes — this is normal residual swelling that resolves gradually.

Will the Hammertoe Come Back?

Surgical correction addresses the structural deformity directly — the contracted joint is released and the bone is realigned. Recurrence rates with modern techniques are low. However, the biomechanical factors that contributed to the hammertoe (foot structure, shoe choices, associated bunion) should also be addressed to minimize any risk. This is where custom orthotics and appropriate footwear play a long-term protective role. More about orthotics.

Is It Worth It?

The patients who are happiest with hammertoe surgery are the ones who waited long enough to know conservative treatment wasn't going to fix it, but didn't wait so long that additional deformities developed. If your toe is rigid, painful, and affecting your shoe choices or walking pattern, correction is straightforward and the relief is lasting.

A consultation will give you a clear picture of your specific situation: what the correction involves, what recovery looks like, and whether now is the right time. Request an appointment or call (760) 728-4800.