Medically reviewed by Dr. Tom Biernacki, DPM — Board-certified foot & ankle surgeon, 3,000+ surgeries performed. Updated April 2026 with current clinical evidence. This article reflects real practice experience from Balance Foot & Ankle Specialists in Howell and Bloomfield Hills, Michigan.
Quick Answer
Hammertoe is an abnormal bend at the middle joint of the toe that can become fixed over time. Flexible hammertoes respond to toe pads, splints, and roomier shoes. Rigid hammertoes that are causing corns or pain often require surgical straightening.
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Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Hammertoe — a sagittal plane deformity of the lesser toes characterized by flexion at the proximal interphalangeal (PIP) joint, with variable involvement of the MTP and distal interphalangeal (DIP) joints — is one of the most common structural foot deformities treated by podiatric surgeons. The clinical classification of hammertoes as flexible (correctable with manual pressure) or rigid (fixed, non-reducible) is the fundamental determinant of surgical approach — flexible hammertoes require only soft tissue procedures, while rigid hammertoes require bony correction.
Deformity Classification and Conservative Care
Hammertoe: PIP joint flexion contracture (the classic deformity); MTP joint is extended or neutral. Claw toe: PIP joint flexion combined with MTP joint hyperextension — typically from intrinsic muscle weakness (neurological) or severe flatfoot. Mallet toe: DIP joint flexion with PIP and MTP neutral — produces dorsal DIP corn and distal pulp pressure. Flexible deformity: passively correctable to straight with the ankle in neutral — intrinsic flexor contracture is the primary deforming force; responsive to physical therapy, accommodative footwear, and toe splinting. Rigid deformity: not passively correctable — bony articular changes and contracted PIP joint capsule are present; requires surgical correction for durable resolution. Conservative management: extra-depth shoes with a wide toe box to accommodate the deformity without dorsal pressure; metatarsal pads to offload pressure calluses under the metatarsal heads; silicone toe sleeves for dorsal PIP corns.
Surgical Correction
Flexible hammertoe: flexor digitorum longus tenotomy (percutaneous FDL release at the plantar base of the toe) corrects flexible deformity by eliminating the deforming flexor force; can be performed in-office under local anesthesia; immediate weight-bearing. Rigid hammertoe: PIP joint arthroplasty (resection arthroplasty — condylectomy of the proximal phalanx head and base of the middle phalanx) eliminates the bony impingement producing the fixed flexion deformity; stabilization with a K-wire or SmartToe implant during healing. Combined MTP joint release: when MTP hyperextension is present, extensor digitorum longus tendon lengthening and MTP joint capsulotomy are performed concurrently to correct both components. Dr. Biernacki at Balance Foot & Ankle classifies hammertoe deformity and provides both in-office flexible correction and surgical rigid correction at our Bloomfield Hills and Howell offices. Call (810) 206-1402.
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Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.
In-Office Treatment at Balance Foot & Ankle
If home care isn’t resolving your hammertoe, a visit with a board-certified podiatrist is the fastest path to accurate diagnosis and a personalized plan. At Balance Foot & Ankle Specialists, Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin offer same-day and next-day appointments at both our Howell and Bloomfield Hills offices. We perform on-site diagnostic ultrasound, digital X-ray, conservative care, advanced regenerative treatments, and minimally invasive surgery when indicated.
Call (810) 206-1402 or request an appointment online. Most insurance plans accepted, including Medicare, Blue Cross Blue Shield, Aetna, Cigna, and United Healthcare.
More Podiatrist-Recommended Hammertoe Essentials
Hammertoe Gel Cushions
No products found.
Protects the raised knuckle from corn/callus formation in closed shoes.
Metatarsal Pad
No products found.
Shifts pressure off the toe joint — reduces the tendon imbalance.
Wide-Toe-Box Walking Shoe
No products found.
Roomy forefoot accommodates the curled toe and prevents friction pain.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
Rigid hammertoes don’t reduce with splinting alone — the tendon and capsule have contracted. If the toe no longer straightens passively, surgical correction restores alignment in one short outpatient visit. Call Balance Foot & Ankle to see whether your deformity is still flexible (and responsive to the conservative tools above) or if it’s time for a 20-minute in-office correction.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Frequently Asked Questions
What causes hammertoes?
Hammertoes are primarily caused by muscle-tendon imbalances in the foot, often from wearing shoes that are too narrow or too short. Flat feet, high arches, arthritis, and certain neurological conditions can also contribute. Genetics play a role in predisposition.
Can hammertoes be fixed without surgery?
Flexible hammertoes (early stage) can be managed with padding, toe splints, wider shoes, and custom orthotics that address the underlying imbalance. Rigid hammertoes (contracted joints) typically require surgery for correction.
How long is hammertoe surgery recovery?
Most hammertoe surgeries allow walking in a surgical shoe immediately. Swelling continues to resolve for 2–3 months. Most patients are back in regular shoes within 6–8 weeks and fully recovered within 3–4 months.
Need Treatment at Balance Foot & Ankle?
Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients at our Howell and Bloomfield Township offices.
Book Online or call (810) 206-1402
Hammertoe Classification & Surgery in Michigan
Balance Foot & Ankle classifies hammertoes as flexible or rigid to determine the best treatment. Our surgeons use tailored techniques for each type to achieve lasting correction.
Learn About Our Hammertoe Treatments → | Book Your Appointment | Call (810) 206-1402
Clinical References
- Coughlin MJ, et al. Operative treatment of the lesser toe deformities. Foot Ankle Int. 2007;28(2):2-12.
- Schrier JC, et al. PIP joint arthroplasty versus arthrodesis for hammertoe: a systematic review. Foot Ankle Surg. 2016;22(4):234-238.
- Caterini R, et al. Percutaneous surgery for correction of hammertoe deformity. Foot Ankle Surg. 2014;20(1):57-61.
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Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
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Bloomfield Hills Office
43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
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Same-week appointments available at both locations.
Book Your AppointmentDifferential Diagnosis: What Else Could It Be?
Several conditions share symptoms with Hammertoe and are commonly misdiagnosed in the first office visit. Considering these alternatives is part of every Balance Foot & Ankle exam:
- Mallet toe. Bend at the distal joint only (DIP), not the middle joint.
- Claw toe. Both joints (PIP + DIP) bent — usually multiple toes, often diabetic.
- Crossover toe (2nd MTP). Drift across the big toe — often plantar plate tear underneath.
If your symptoms don’t fit the textbook pattern, ask your podiatrist which differentials they ruled out — that conversation often shortcuts months of trial-and-error treatment.
In Our Clinic
Hammertoes come to our clinic in two flavors: flexible (the toe still passively straightens) and rigid (it doesn’t). For flexible hammertoes we use gel toe crests, roomier toe boxes, custom orthotics to address the underlying instability, and sometimes night splints. Rigid hammertoes with a corn on top of the PIP joint, or a callus under the metatarsal head, usually need a minor outpatient procedure (PIP arthroplasty or fusion) to straighten the toe. The patients who wait too long develop fixed deformities and skin breakdown — we would much rather address a flexible hammertoe early.
Most Common Mistake We See
The most common mistake we see is: Cutting corns at home with scissors or razors. Fix: professional podiatric enucleation with sterile instruments prevents infection and recurrence.
Warning Signs That Need Same-Day Care
Seek immediate evaluation at Balance Foot & Ankle if you experience any of the following:
- Open wound under the bent toe
- Inability to straighten the toe even passively
- Diabetic skin breakdown at the toe joint
- Cold or blue discolouration of the toe
Call (810) 206-1402 — same-day and next-day appointments at our Howell and Bloomfield Hills offices.
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
- Hallux Valgus (Bunions): Evaluation and Management (PubMed)
- Bunions (Mayo Clinic)