Hammertoe Surgery

Hammertoe surgery fixes a toe that’s bent at the middle joint (usually the second toe) because the tendons/ligaments are too tight or the joint has become rigid. The goal is to straighten the toe, relieve pain from shoe pressure/corns, and restore function.

How it works (depends on whether the toe is flexible or rigid):

• Flexible deformity (early stage)
  • The surgeon lengthens or releases tight tendons and ligaments (often the flexor tendon) so the toe can straighten.
  • Sometimes a tendon transfer moves the flexor tendon to the top of the toe to help hold it straight.
• Rigid deformity (fixed bend)
  • PIP joint arthroplasty: removes a small piece of bone at the joint to allow the toe to straighten.
  • PIP joint fusion (arthrodesis): removes joint cartilage and aligns the bones to fuse straight. A temporary pin, screw, or implant holds it while it heals. Fusion is common for durable correction.
• Additional procedures if needed
  • Extensor tendon lengthening if the top of the toe is tight.
  • Metatarsal shortening osteotomy (Weil osteotomy) if the joint at the ball of the foot is overloaded.
  • Corn/callus removal and skin/bursa care.
  • Address bunion or crossover toe if contributing to deformity.

Shorter wait times

Consults and surgery dates are typically scheduled in weeks—not months—which means faster return to work, sport, and caregiving duties.

Choice & control

Ability to choose a surgeon based on what's important to you (i.e. specific expertise, experience, qualifications, personal connection).

Certainty

Private pathways typically provide a clear quote and surgery date/timeline, so you can arrange time off, caregiver help, and rehab. This certainty can ease anxiety and help families plan for recovery.

Preventing further decline

• Progression risk: Flexible hammertoes tend to become rigid over time, making correction more involved and recovery longer.
• Skin breakdown: Ongoing rubbing can cause corns, ulcers, and infections—especially in diabetes or poor circulation.
• Adjacent problems: Untreated deformity can shift pressure to other toes and the ball of the foot, causing metatarsalgia or crossover toe.
• Complexity creep: Delays can mean needing bone procedures (fusion/osteotomy) instead of simpler soft‑tissue balancing later.

1. ‍Confirm your diagnosis. Most patients start with a family doctor or specialist who confirms that hammertoe surgery is needed.
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2. Research. Explore surgeons who specialize in private hammertoe surgery.
   • You can find surgeons in Vancouver, British Columbia; Calgary, Alberta; Toronto, Ontario; and Montréal, Québec on our app, and review qualifications, as well as pricing.
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3. Schedule an initial consultation. Most surgeons offer in-clinic and online consults.
   
   • Consultations are usually booked within days or a few weeks.
   • Note: expect a consultation fee between $150 - $350.
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4. Consultation. The surgeon will review your condition, symptoms, and any previous treatments or diagnostics, such as x-rays or MRIs.
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5. ‍Post consultation. The surgeon will then review your case and provide surgical options based on your needs; review the risks and expected outcomes; and present pricing and scheduling options.
   
   • Because the procedure is not covered by your provincial health plan when done privately, you’ll need to review the quoted cost and consider payment options (out-of-pocket, private insurance, or financing).
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6. Schedule your surgery date. Once you confirm the procedure and payment, the clinic will schedule your surgery—generally within a few weeks.
   
   • Plan for travel and accommodation, since the surgery will likely take place outside your home province.
   • Expect pre-surgery preparation, and possibly some pre-surgery tests.

Hammertoe surgery usually takes 30-60 minutes.

• Numb the foot.
• Small cut over the bent joint.
• Release tight tendon/ligament.
• Trim a small piece of bone or fuse the joint straight.
• Hold it with a pin/screw; close the skin.

The recovery process varies patient to patient. Your recovery might look quite different, so please seek further guidance from your surgeon. In general here is what you can expect:

Week 1:

• Goals: Pain and swelling management, wound protection, initial basic movement.

• Activities:
  
  • Same day discharge, likely with a post-operative shoe or sandal.
  • Elevated rest for most of the day.
  • Focus on keeping the area clean to avoid infection.
  • Limited walking or weight-bearing.

Weeks 2-4:

• Goals: Wound healing and slowly ramping up activity.
  

• Activities:
  
  • Wound care, possibly removing stitches.
  • Transition to regular footwear.
  • Increase walking distance and slowly resume normal daily activities.
  • Start physiotherapy, as directed.
  • Returning to work, depending on how physically demanding your job is.
  • Potentially driving if you can perform an emergency stop (i.e. slamming on the breaks).

Weeks 5-12:

• Goals: Increase mobility and strength.

• Activities:
  
  • Continue to push for longer distances walking.
  • Resuming most normal activities.
  • Returning to work where spend a lot of time on your feet.

Weeks 13-52:

• Goals: Regain full or near-full range of motion, recover your lost strength and stamina, and slowly return to normal activity levels and sports.

• Activities:
  
  • Physical therapy may continue the entire first year post operation, gradually bringing you back to your activity levels pre-surgery.
  • Daily exercises are no longer essential once you achieve normal range of motion and strength, but routine exercise is encouraged to keep muscles strong.
  • You will be able to return to low impact sports like golf, tennis, swimming, or cycling. For anything high impact, please consult your surgeon and physio.

Private clinics in Canada charge between $4,000 - $8,000 per foot.

In the United States, the average cost is CA$9,600 per foot.

Costs vary so much because of location, surgeon experience, facility type, complexity, and included services (some clinics offer all-inclusive, while others charge separately for anesthesia, followup care, etc.).

What’s included

Most quotes for private hammertoe surgery cover:

• Surgeon fee (and assistant if used).
• Facility fees (operating room, nursing, supplies).
• Anesthesia (local with or without sedation; sometimes regional/general).
• Standard implants/fixation (pins/screws/plates) for routine cases.
• Routine post-op care: first follow-up(s), dressing changes, and pin removal if applicable.
• Basic post-op shoe/boot and standard discharge meds given in facility (varies).

What’s usually not included:

• Pre-op consult/imaging beyond basics (x-rays often included; advanced imaging rarely included).
• Additional hardware or special implants for complex/revision cases.
• Pathology fees (rarely needed) and unexpected overnight stays.
• Extended physiotherapy or custom orthotics after the early recovery phase.
• Medications after you go home (pain meds, antibiotics if prescribed).
• Travel and accommodation if you’re coming from out of town.
• Fees for complication management beyond the routine global period (varies by clinic policy).

Insurance and financing options

• Private health insurance: Some plans may cover part of the costs, such as hospital fees. It’s important to check your policy directly.
• Financing plans: Many clinics offer monthly payment options to help spread out the cost. Learn more about your financing options here.‍
• Medical Expense Tax Credit (METC): This is a non-refundable credit that reduces your taxes when you pay out-of-pocket for eligible medical expenses. Learn more about how to claim METC for private surgeries.

Choosing your surgeon is one of the benefits of going the private route. Here’s what to consider and the key questions to bring to your hammertoe consultation.

What to look for

• Experience and volume
  • Ask how many hammertoe/forefoot surgeries they perform each year, and their mix of soft‑tissue procedures vs PIP fusion/osteotomy and complex/revision cases.
• Credentials and training
  • Confirm licensure with the provincial college (e.g., CPSO in Ontario, CPSBC in BC, CPSA in Alberta).
  • Look for FRCSC-certified orthopaedic surgeons or podiatric surgeons with recognized surgical credentials and hospital privileges.
• Specialization
  • Prefer surgeons focused on foot and ankle or forefoot reconstruction; ask about additional fellowships or advanced courses in forefoot surgery and fixation techniques.
• Outcomes and protocols
  • Ask about infection rates, nonunion rates, hardware removal rates, and unplanned re-operations.
  • Review their standardized postoperative protocol (weight-bearing rules, pin care if used, footwear timeline).
• Facility accreditation
  
  • ‍Make sure the clinic is accredited by national bodies such as Accreditation Canada or the Canadian Association for Accreditation of Ambulatory Surgical Facilities (CAAASF).‍
• Support services‍
  
  • Look for coordinated aftercare, clear wound care instructions, pin removal scheduling, and facilitated access to foot‑savvy physiotherapy and orthotics.

Questions to ask during your hammertoe surgery consultation

Surgeon and surgery plan

• How many hammertoe/forefoot procedures do you perform each year? What are your complication and revision rates?
• For my toe(s), do you recommend soft‑tissue balancing, PIP joint fusion, or an osteotomy? Why?
• What fixation do you prefer (temporary K‑wire pins extending beyond the toe vs buried screws/implants)? Pros/cons and removal plan?
• Will you correct related issues at the same time (e.g., crossover toe, bunion, metatarsalgia)? How does that change recovery?
• What anesthesia do you recommend (local with or without sedation vs regional/general) and why?
• Is this outpatient in an ambulatory center? Any chance I’d need an overnight stay?

Recovery and aftercare

• Weight‑bearing: In a surgical shoe/boot right away or limited/non‑weight‑bearing? For how long?
• When can I: Return to desk work, drive, stand all day, wear regular shoes, resume sports?
• How do you minimize stiffness or floating toe? What’s your taping/strapping protocol?
• If using pins, when are they removed, and is that included in the fee?
• What red flags should prompt me to call you or go to the ER?
• Who do I contact post‑op (direct phone/email)? Typical response time?

Costs and logistics

• What exactly is included in my quote (surgeon, facility, anesthesia, implants, dressings, pin removal, follow‑ups)? What could add cost (additional toes, hardware upgrades, unexpected procedures, overnight stay)?
• If complications occur or a revision is needed, how are costs handled? Do you have a revision policy?
• If I’m traveling from another province, how are follow‑ups managed (virtual vs in‑person)? What’s the schedule?