Hammertoe Treatment in Los Angeles
A hammertoe is not simply a corn or a bump on top of the toe. Dr. Alexis Dixon, MD, FAAOS, a board-certified orthopaedic foot & ankle surgeon in Marina del Rey, treats the tendon and bone structure underneath, so you are more comfortable in your actual shoe size.
Foot & Ankle Conditions
What Is a Hammertoe?
Hammertoes are a general term for deformities of the lesser toes caused by a muscular imbalance. There are a variety of types including claw toes, mallet toes, and the more common and classic hammertoes. The treatment is similar for all, so the same term is used for all.
They are not simply corns or bumps on top of the toe, though this may be the first thing that you notice. The tendon and bone structure beneath is abnormal. Therefore, correction of the hammering is not simply the removal of a bump. It is a complex reconstructive surgery in which the shape of the foot is changed. It may even lead to pain in the bottom of the ball of the foot when more severe.
Get an Accurate Diagnosis
Diagnosis
A set of high-quality weight-bearing (standing) x-rays are required for diagnosis, as well as a thorough physical examination. Dr. Dixon takes specific x-rays in her office to ensure the highest quality of x-rays. Be prepared for a new set of x-rays in her office. Not all x-rays are the same.
Symptoms
A corn or a bump on top of the toe may be the first thing you notice. Common symptoms include:
- A corn or a bump on top of the toe
- A hammertoe that rubs in shoes or sandals
- Pain in the bottom of the ball of the foot when the deformity is more severe
What Causes It?
Hammertoes are caused by a muscular imbalance. This can be caused by improper shoe wear such as tight, pointed shoes, or they can be caused by hereditary conditions. On occasion, they can be worsened by trauma. If there is a bunion present causing the hammertoe, the bunion must also be addressed, or the hammertoe will recur.
Conservative First, Surgical When Needed
Treatment Options
Treatment starts with shoe wear modification and moves to surgery only when the pain cannot be treated any other way.
Nonsurgical
Shoe Wear Modification
It is important to avoid high heels and narrow, pointed toes that predispose to hammertoe formation and pain. Shoes with a soft upper are preferred. Shoes can be taken to a cobbler to be stretched around the hammertoe.
Orthotics and Braces
Orthotics and braces do not help with hammertoes. There are no devices that will reverse the deformity. However, Budin splints may be used to temporarily alleviate pain.
Surgery
Surgical intervention may be necessary when the pain is not able to be treated via shoe wear modification. This requires fusion of one of the joints in the toe to straighten the toe, as well as soft tissue procedures to bring the toe down. Often this also requires shortening of the metatarsal. If there is a bunion present causing the hammertoe, the bunion must also be addressed, or the hammertoe will recur. Surgery usually entails use of temporary pins to hold the toe in place for 4 to 6 weeks. These will be removed in the office and do not require anesthesia.
What NOT to Expect
Hammertoe surgery is a complex reconstructive surgery. Be cautious of any promise of a pain-free return to normal activity in the short term. There is no way to accelerate soft tissue and bone healing. Hammertoe surgery will not change your shoe size. It will make you more comfortable in your actual shoe size. There may be a mild shortening of the toe, but the length of the toe is dictated by the function of the surgery and not purely cosmesis. Hammertoe surgery is not meant for purely cosmetic purposes. It is possible to convert a pain-free hammertoe to a painful but beautiful foot. For this reason, it is only medically indicated to operate on toes that cause discomfort.
Why Choose a Physician
Why See a Board-Certified Orthopaedic Surgeon (MD)?
See a board-certified orthopaedic surgeon with accredited fellowship training in foot and ankle surgery about your hammertoes. Foot and ankle orthopaedic surgeons complete medical school, five years of residency training in orthopaedic surgery, and a yearlong advanced fellowship focused on foot and ankle care. They are the only healthcare providers with the depth and breadth of experience to treat the gamut of foot and ankle conditions, from bunions and hammertoe to arthritis and traumatic injuries. It is highly recommended to always consult with a foot and ankle orthopaedic surgeon before planning surgery in the region.
After Treatment
What Recovery Looks Like
Because hammertoes will recur with shoes that recreate the deformity, the rehabilitation from this surgery is prolonged open toe shoe wear, followed by allowance of tennis shoes no sooner than four months postoperatively. If the metatarsal is shortened, there is a period of non-weight bearing as well. Be prepared for a postoperative protocol that allows for downtime as well as time in a medical shoe. Normal shoe wear will not be immediate and can lead to recurrence. As is often the case, the best things take a bit of effort and time but are generally worth the investment.
After surgery
Prolonged open-toe shoe wear. If the metatarsal is shortened, there is also a period of non-weight-bearing.
4 months
Tennis shoes are allowed no sooner than four months after surgery.
Normal shoes
Not immediate. Rushing back into shoes that recreate the deformity can lead to recurrence.
What Patients Say
Patient Reviews
Patient Questions
Hammertoe FAQs
About Your Surgeon
Alexis E. Dixon, MD, FAAOS
Dr. Dixon is a board-certified orthopaedic foot & ankle surgeon practicing in Marina Del Rey, California. USC-trained and named an LA Magazine Top Doctor since 2017, she combines surgical expertise with a conservative-first philosophy, treating the underlying joint and tendon, not just the symptom. She treats ganglion cysts, bunions, Achilles injuries, plantar fasciitis, fractures, and the full range of foot and ankle conditions.
Meet Dr. Dixon →Living With a Painful Hammertoe? Get a Real Diagnosis.
If your toe is bent or painful in your shoes, get an accurate diagnosis and a clear plan from a board-certified orthopaedic foot & ankle surgeon in Marina del Rey.
Sources
References
The patient handout for this condition draws on the following sources.