Hammer toe surgery: what is done, how recovery goes, and what to have at home
We research products from makers' specs and health sources; we do not run hands-on tests. Links to Amazon may earn us a commission at no cost to you. How this works.
- Foam leg elevation wedge. Best for: Keeping the foot above heart level in the first days. See options on Amazon
- Flexible reusable gel cold packs for the foot. Best for: Icing swelling in the first days after surgery. See options on Amazon
- Waterproof foot cast and dressing cover. Best for: Showering while the dressing must stay dry. See options on Amazon
- Open-toe adjustable sandals or post-op style shoe. Best for: The weeks after the surgical shoe, while the foot is still swollen. See options on Amazon
When surgery is considered
AAOS OrthoInfo says surgery is considered when the toe joint is rigid or when nonsurgical care does not relieve symptoms. FootCareMD adds that it is an option when a hammertoe still hurts after padding, shoe changes and stretching, limits normal activities, or makes it hard to wear shoes.
FootCareMD says it may not be recommended for people with an active infection, poor circulation or a serious illness, and advises going over your health history and risks with a foot and ankle orthopaedic surgeon before deciding. If you have not tried nonsurgical care yet, start with hammer toe treatment without surgery.
The main procedures
The procedure depends on whether the toe is still flexible. Hammertoes often occur with bunions, and FootCareMD suggests considering correcting the other deformities at the same time.
| Toe type | Common procedure | What it does |
|---|---|---|
| Flexible | Tendon lengthening or release | Eases the tight tendons pulling the toe down |
| Flexible | Tendon transfer | Moves a tendon from the bottom of the toe to the top so it helps hold the toe flat |
| Rigid | Joint resection with pinning | Removes the end of the bone at the stiff joint; pins hold the toe straight, and the area fills in with scar tissue after they come out |
| Rigid | Joint fusion (arthrodesis) | Pins, screws or an implant hold the bone ends until they fuse into solid bone |
Most people go home the same day. FootCareMD says you may be fully asleep or given an injection that numbs the foot. An NHS hospital leaflet notes some people stay overnight, depending on their health and home situation.
Recovery timeline
Your surgeon's instructions come first. As a general guide from the cited hospitals:
| When | What usually happens |
|---|---|
| First days | Kaiser Permanente advises, for the first 3 days, propping the foot above heart level whenever you sit or lie down, and ice for 10 to 20 minutes every 1 to 2 hours while awake, with a thin cloth between ice and skin |
| Until stitches are out | FootCareMD says to lie down with the foot raised to heart level for the first few days. Kaiser Permanente says to keep the bandage dry and not touch the surgery area. |
| About 2 weeks | Stitches out, Kaiser Permanente says. FootCareMD gives 2 to 3 weeks. |
| 3 to 6 weeks | Kaiser Permanente says the special shoe is worn for 3 to 6 weeks and temporary pins come out at 3 to 6 weeks; the NHS leaflet gives 4 to 6 weeks for a wire |
| Up to 4 to 6 weeks | AAOS says stiffness, swelling and redness in the toe may last this long |
| Months | FootCareMD says swelling may take many months to settle. The NHS leaflet says recovery is often over 6 months and occasionally 1 year. |
Weight bearing in the post-op shoe is usually allowed from the start, but AAOS advises limiting activity and elevating the foot while it recovers. FootCareMD says you may not be able to drive for several weeks after surgery on the right foot, and Kaiser Permanente says to ask your doctor when it is safe.
Recovery supplies to set up before surgery day
- Pillows or a leg wedge to keep the foot above heart level for the first days. See leg wedge pillows.
- Two or more reusable cold packs and a thin cloth, so one can chill while you use the other. See foot ice packs.
- A waterproof cast or dressing cover for showers. Kaiser Permanente says to keep the bandage dry and avoid baths for the first 2 weeks, and FootCareMD says not to put the foot underwater until stitches and pins are out.
- Roomy, adjustable sandals or a wide shoe for the transition. The NHS leaflet notes sandals are often needed at first because of swelling.
- The post-op shoe or boot your surgical team gives you. Use theirs; do not swap it for your own shoes until you are told to.
Risks and what the toe is like afterward
FootCareMD says complications are not common. The sources list:
- Recurrence. FootCareMD calls it possible but unlikely; the NHS leaflet notes further surgery may be needed if it happens.
- Stiffness. FootCareMD says most procedures leave the toe somewhat stiffer. A fused joint no longer bends, and AAOS notes the toe may end up slightly longer or shorter.
- Bone that does not fuse, which the NHS leaflet says is more likely in people who smoke or have diabetes.
- Numbness, which the NHS leaflet says usually resolves but may be permanent.
- Infection, blood clots, bleeding and anesthesia risks, which FootCareMD lists.
The goal, as FootCareMD puts it, is a painless toe that fits easily into a shoe.
What to look for when you buy
Foam leg elevation wedge
Best for: Keeping the foot above heart level in the first days
Kaiser Permanente advises propping the foot and leg above heart level whenever you sit or lie down for the first 3 days.
Watch out: Pick one long enough to support the calf so the heel is not taking all the pressure.
See options on AmazonFlexible reusable gel cold packs for the foot
Best for: Icing swelling in the first days after surgery
Kaiser Permanente recommends ice for 10 to 20 minutes at a time, every 1 to 2 hours, for the first 3 days.
Watch out: Always use a thin cloth between pack and skin, keep the dressing dry, and follow your surgeon if they advise otherwise.
See options on AmazonWaterproof foot cast and dressing cover
Best for: Showering while the dressing must stay dry
Kaiser Permanente says to keep the bandage dry and not to take a bath for the first 2 weeks, and FootCareMD says not to put the foot underwater until stitches and pins are out.
Watch out: A cover is for showers, not soaking; no baths until your surgeon allows it.
See options on AmazonOpen-toe adjustable sandals or post-op style shoe
Best for: The weeks after the surgical shoe, while the foot is still swollen
The NHS leaflet notes a sandal is often needed at first to make room for swelling.
Watch out: Do not replace the shoe your surgical team provided until they clear you.
See options on AmazonQuestions people ask
- How long does it take to recover from hammer toe surgery?
- Expect several weeks before normal shoes and months before swelling fully settles. The NHS leaflet says recovery is often over 6 months and occasionally up to 1 year.
- Can I walk after hammer toe surgery?
- Usually yes, in the special shoe or boot. AAOS says weight bearing is possible right away, but activity should be limited and the foot kept elevated.
- When do the pins come out after hammer toe surgery?
- Kaiser Permanente gives 3 to 6 weeks and the NHS leaflet 4 to 6 weeks. FootCareMD says pins come out in the office and removal is not painful because they loosen over time.
- Is hammer toe surgery painful?
- Some pain and swelling are expected, and Kaiser Permanente says symptoms can last weeks to months while slowly improving. Call your doctor if pain does not get better after you take pain medicine, as Kaiser Permanente advises.
- Can a hammer toe come back after surgery?
- It can, though FootCareMD calls it possible but unlikely. The NHS leaflet notes that further surgery may be needed if the deformity comes back.
Sources
- Hammertoe Surgery (footcaremd.org), FootCareMD (American Orthopaedic Foot and Ankle Society)
- Hammer Toe: Comprehensive Guide (orthoinfo.org), AAOS OrthoInfo
- Surgery for Hammer Toe: What to Expect at Home (healthy.kaiserpermanente.org), Kaiser Permanente
- Claw, Hammer and Mallet Toe Deformities (patient information) (nnuh.nhs.uk), Norfolk and Norwich University Hospitals NHS Foundation Trust