Curved toes, also known as hammertoes, are a common foot deformity that causes one or more of the toes to bend downward in a claw-like shape. This condition affects about 2-3% of the population and can cause significant pain, irritation, and difficulty walking. While there are nonsurgical treatments available, many people wonder if surgery is necessary to fully straighten curled toes. This article provides an overview of hammertoe causes, nonsurgical treatments, surgical options, and recovery.
What causes hammertoes?
There are several factors that can contribute to the development of hammertoes:
- Muscle/tendon imbalance – The tendons along the top of the foot may be too tight and force the toes to curl downward.
- Joint stiffness – Arthritis or damage in the toe joints can lead to restricted, bent positions.
- Nerve injury – Damage to the nerves in the foot can disrupt proper muscle functioning.
- Footwear – Shoes that are too tight or have high heels can increase pressure on toes and force them out of position.
- Trauma – Injuries, sprains, or fractures involving the toes can sometimes lead to hammertoe deformities later on.
- Genetics – Some people are simply born with muscle or bone structures that increase risk.
In most cases, it’s a combination of factors that ultimately cause the characteristic bent appearance of hammertoes. The deformity usually develops gradually over time as the foot structure weakens.
Nonsurgical treatments
In mild to moderate cases of hammertoe, nonsurgical methods may be effective in straightening curled toes:
- Pads and straps – Special cushions or straps can redistribute pressure on the affected toes to relieve pain and pressure.
- Toe splints or braces – Devices worn over the forefoot can gently pull toes back into proper position over time.
- Shoe modifications – Wearing shoes with extra width and depth or using custom orthotics can relieve crowding issues.
- Medications – Anti-inflammatory drugs can help control pain and swelling in irritated toes.
- Injections – Corticosteroid injections into the toe joints can reduce inflammation and stiffness.
- Physical therapy – Exercises to stretch tight muscles and strengthen weakened ones can restore balance.
These conservative treatments focus on easing symptoms and may temporarily straighten bent toes. However, they do not address the underlying muscle and bone deformities causing hammertoes. Without this, curving often returns once treatment stops. Surgery is usually the best option for permanent, lasting straightening of curled toes.
Surgical procedures
If conservative treatments fail to adequately straighten bent toes, there are a few surgical procedures that can correct hammertoe deformities. The surgery chosen depends on factors like severity, location, and flexibility of the affected toes.
Joint resection
One of the most common procedures, this involves removing a small section of the deformed joint in the bent toe. Removing part of the joint relieves tension on the toe and allows it to straighten out. Pins or screws may be used to hold the toe in place while the joint heals. This is best for flexible toe deformities.
Tendon/capsule release
In this procedure, the surgeon lengthens or releases the contracted tendon and capsule surrounding the toe joint. This gives the toe flexibility to unbend and straighten. It is effective for rigid, fixed hammertoe deformities.
Fusion
If toes are severely contracted and unresponsive to other surgeries, fusion may be done. This permanently joins the two toe bones together so they cannot bend. While the toe no longer moves, it should be straighter.
| Procedure | Best For | Process |
|---|---|---|
| Joint resection | Flexible hammertoes | Remove part of deformed toe joint |
| Tendon/capsule release | Fixed, rigid hammertoes | Loosen contracted tendon & tissues around joint |
| Fusion | Severe, inflexible hammertoes | Fuse toe bones together in straightened position |
In some cases, a combination of techniques may be used to fully correct curvature and realign the toe. Surgery is typically done under local anesthesia, or general anesthesia in more extensive cases. Patients are usually able to go home the same day.
Recovery and outlook
Proper post-operative care is important to ensure straightened toes heal properly and results last. Typical recovery instructions include:
- Keeping foot elevated above heart level to reduce swelling
- Wearing prescribed shoe gear to stabilize toes
- Using crutches to avoid putting weight on the foot
- Attending physical therapy sessions to improve flexibility and strength
- Avoiding wet environments until healing completes
Complete recovery typically takes 2-3 months for skin to fully close and toe joints to completely heal. Some people experience temporary numbness in the toes, which usually subsides with time. Over-the-counter pain relievers help manage discomfort.
Properly performed hammertoe surgery allows for excellent straightening of curled toes in about 90% of cases. However, the deformity may return over time without proper maintenance. Wearing appropriate footwear and using orthotics helps reduce recurrence risk. With careful monitoring and prevention measures, straightened toes can remain properly aligned for many years after corrective surgery.
FAQs about straightening curled toes
How long does it take for hammertoe surgery to heal?
Full recovery typically takes around 2-3 months. Swelling subsides within a few weeks, though complete internal healing of bone, joint, and soft tissues extends to 2-3 months.
Is hammertoe surgery painful?
There is some moderate pain, swelling, and stiffness expected after surgery that is managed with medication. Elevation, ice, rest, and post-op shoes also help relieve surgical discomfort.
Can hammertoe surgery be reversed?
In some cases where fusion was performed and the toe no longer moves, the fusion can be reversed if needed to help improve function. However, outcomes are often better if revision surgery can be avoided.
Can I wear high heels after hammertoe surgery?
It’s recommended to avoid high heels for at least 3 months after surgery to allow proper healing. After that, heels should be limited to occasional wear, as they can increase recurrence risk.
Do toe straightening results last?
With proper footwear, orthotics, and preventative care, straightened toes remain properly realigned for many years after surgery in about 90% of patients.
Conclusion
Hammertoes are a very common foot deformity, but several effective treatments are available to straighten curled toes. Nonsurgical options like splints, straps, and physical therapy can provide temporary relief and straightening. However, surgery is usually necessary to permanently realign bent toes and address the underlying bone and muscle structure abnormalities causing hammertoes. The specific technique used depends on factors like flexibility and severity. With proper postoperative care and preventative measures, straightened toes can remain properly aligned for many years after corrective surgery in the majority of patients.
