A hammertoe is when your toe buckles or bends as a result of an unstable foot. This can range from a mild twisting of the toe to such a severe buckling that the toe sits on the top of your foot. Dress shoes for women and men are not made with ample room for the toes. When a toe is buckled there is pressure and rubbing of the toe against the shoe leading to pain, redness, and formation of hard skin known as corns and calluses.
Hammertoe surgery has been described in a previous article where I talked about the difference between correcting the 2nd and 3rd toes vs. the 4th and 5th. To review the 2nd and 3rd toes usually involve toe fusion surgery, while the 4th and 5th involve toe joint surgery where the joint is removed. Muscles and tendons are often rebalanced around the base of the toe and sometimes work further back in the metatarsal is needed. Cosmetic surgery on a hammertoe can mean hiding the scar or just the fact that I will make your toe look better.
Many people have one toe longer than the others and consider this unsightly. Mind you this toe is not buckled and not painful, but some people want this toe shortened. A doctor might decide to remove some bone from the toe shortening this long toe and performing toe fusion surgery thinking he is making the toe stable. Unfortunately there are tendons in each and every toe that are not shortened with the toe because tendons don’t heal well. Tendons rely on being a specific length, for geeks like me that would be 125% of the muscle/tendon resting length, in order to work. So yes I can shorten your toe and in turn I have just made your toe unstable. I might have performed toe fusion surgery to make that toe joint stable, but the other joints are not, so your toe buckles and now you have a toe sticking straight up in the air. Would that be worth it to you? As the podiatrist who spends a great deal of time fixing poor surgical outcomes, I can tell you it is much more difficult for me to correct this problem.
What exactly do I mean by hiding your scar? Most hammertoe surgery is done through the top of the toe. This is beneficial if I have to address the tendons, ligaments, joint capsule, and even bone at the base of the toe or metatarsal. If your toe can be treated just by toe joint surgery alone than I can make the incision on the side of your toe so that no one will ever see your scar. The sacrifice I am making to use this incision is that I cannot rebalance the joint in the ball of your foot. If your toe is buckled and you have pain in the ball of your foot do not expect a scar any where other than the top of your toe.
Cosmetic hammertoe surgery means making your toe look better and relieving pain. I have talked about some of the risks and sacrifices that are involved in making this decision. Remember what I always say, feet are like snowflakes, no two are alike. Your surgery will be different from your friends and it should be. Don’t forget to read the articles on toe surgery without the pin and recovery from hammertoe surgery.