HomeSurgery guidesHammer toe correction (PIPJ arthroplasty or fusion)
Forefoot surgery

Hammer toe correction (PIPJ arthroplasty or fusion)

Hammer toe correction straightens a permanently bent lesser toe. Depending on the severity and flexibility of the deformity, the procedure may involve releasing tight soft tissues, removing a small piece of bone, or fusing the joint. Often combined with bunion surgery.

Before surgery
The day of surgery
In hospital
Going home
Recovery week by week

Step 1: Your pre-operative assessment

ℹ️ This appointment takes place 2-4 weeks before surgery. Most patients are well, so the assessment is straightforward.

You will have routine pre-operative checks. The specific procedure (soft tissue release, arthroplasty, or fusion) is confirmed based on the rigidity of the deformity.

What will happen at the pre-assessment?

Blood tests and an ECG

Standard pre-operative checks.

Medication review

Blood thinners may need to be paused.

Anaesthetic discussion

Usually under regional ankle block with sedation. The block gives several hours of post-operative pain relief.

Wire fixation

A small temporary wire (K-wire) often holds the toe straight for 4-6 weeks, protruding through the tip of the toe. This is removed in clinic.

Prepare your home

You will wear a heel-weight-bearing surgical shoe for around 6 weeks. Arrange help with shopping and stairs.

The day of surgery

ℹ️ You will be given a specific arrival time. Do not eat or drink (other than clear water up to 2 hours before) from midnight the night before. Bring your medication list and any documents sent by the hospital.

Arrive at the time given

You will be admitted to the ward or day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.

Consent and marking

Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.

Anaesthetic

You will meet the anaesthetist in the anaesthetic room. Once anaesthesia is established, the procedure will begin.

Recovery room

After surgery you will wake in the recovery room where nurses monitor your vital signs until you are stable and comfortable.

In hospital

Most foot and ankle surgery is performed as a day case, meaning you go home the same day. More complex procedures such as ankle replacement or flat foot reconstruction usually require 1-3 nights in hospital. Before discharge, the team will check your pain is controlled, give you wound care instructions, and confirm your follow-up appointment.

Pain control

You will be given oral pain relief before discharge. Take it regularly for the first 48 hours rather than waiting until pain is severe.

Wound check and dressing

A nurse will check the wound before you leave and explain how to keep it clean and dry.

Crutches and weight-bearing instructions

You will be shown how to use crutches and given clear instructions about weight-bearing on your operated foot.

Discharge letter and follow-up

You will receive a letter for your GP and details of your next outpatient appointment, usually at 2 weeks for a wound check.

You must not drive yourself home

Arrange for a family member or friend to collect you. You must not drive after a general anaesthetic or sedation.

Going home

⚠️ Important: The K-wire keeps the toe straight while healing occurs. Do not catch it on bedding or knock it. Once removed, the toe may be slightly stiff, but this usually improves with time and gentle exercises.

Elevate your foot

Keep the foot elevated above the level of your heart for as much of the day as possible during the first 2 weeks. This significantly reduces swelling and helps healing.

Keep the wound clean and dry

Avoid getting the wound wet until it is fully healed, usually 10-14 days. Use a waterproof cover when showering.

Take your pain relief as prescribed

Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, ibuprofen if appropriate) is more effective than taking it only when needed.

Attend your wound check appointment

This is usually 2 weeks after surgery. Sutures or clips will be removed if used.

When to contact the hospital

Seek urgent advice if you develop increasing redness, warmth, swelling, discharge from the wound, calf pain or swelling (possible DVT), shortness of breath, or a temperature above 38°C.

Recovery week by week

Weeks 0-2

Heel-weight-bearing shoe, elevation

Foot wrapped, kept elevated. Walking through the heel in surgical shoe.

Week 2

Wound check

Stitches removed.

Weeks 4-6

K-wire removal

The K-wire (if used) is removed in clinic (a brief and usually painless procedure).

Weeks 6-8

Transition to normal shoes

Out of surgical shoe and back into wide, comfortable footwear.

3-6 months

Final settling

Swelling resolves. Return to all desired activities.

Common questions

Can the toe still bend afterwards?

If a fusion was performed, the joint is permanently stiff. If an arthroplasty (joint resection) was performed, some movement is retained but the toe may be slightly floppy.

Can I have several toes corrected together?

Yes. Multiple toes are commonly corrected at the same time, often along with bunion surgery.

How long off work?

Desk work: 1-2 weeks. Standing work: 4-8 weeks. Manual work: 8-12 weeks.

When can I drive?

For right-sided surgery, around 6-8 weeks. Left side in an automatic, around 2 weeks if comfortable.

Common questions

Your questions, answered

Plain-English answers to the things people most often ask, grounded in published guidance. Tap a question to open it.

Your operationWhat does the operation involve?

The bent toe is straightened by reshaping or fusing a small joint, sometimes held temporarily with a fine wire or a small implant, and tight tendons may be released.

It is usually a day case.

Sources  AAOS OrthoInfo · BOFAS
AnaesthesiaWhat anaesthetic is used?

Often a local or regional block, sometimes with sedation or a general anaesthetic.

Your team will choose what suits you.

Sources  NHS
Getting backWhat is recovery like?

Expect a stiff-soled post-operative shoe for some weeks. If a wire is used it is usually removed in clinic, which is quick.

Swelling in the toe can take months to settle.

Sources  AAOS OrthoInfo
Your choiceWill the toe still bend afterwards?

If the toe is fused it will be straight but stiff, which is expected and usually well tolerated.

Straightness and comfort in shoes are the goals.

Sources  AAOS OrthoInfo
PreparingHow should I prepare?

Arrange a lift home, have roomy footwear ready, and plan time off, which is longer for jobs on your feet.

Keep the foot elevated in the first days.

Sources  NHS
UrgentWhat needs urgent review?

Spreading redness, discharge, a temperature, or a cold or blue toe need prompt help.

Calf or chest symptoms also need urgent attention.

Sources  NHS
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