A hammertoe is a contracture or bending of one or both joints of the second, third, fourth, or fifth toes. The contracture of the toes is a result of a muscle / tendon imbalance between the tendons on the top and the tendons on the bottom of the toe. As a result of the deformity the toe resembles a hammer.

Besides the structural problems and inflammation that they can cause, hammertoes can produce painful corns and calluses at the affected joints.  Even without corns and calluses, hammertoes can cause pain because the joint itself may become dislocated.

Conservative treatment includes padding, new shoes, stretching, or splinting.  If conservative treatment fails or the hammertoes progress to the point where conservative treatment is no longer a viable option, surgical intervention may be needed to correct the deformity.

Dr. Nunez does a minimally invasive ambulatory surgical technique to correct hammertoes.  It involves making “extremely small incision” on the bottom of the affected toes to correct the hammertoe deformity.

There is no need for a long open incision thus causing minimal injury to the adjacent tissues which results in reduced swelling, pain, and recovery time.  

MIS surgeons are able to rely on a compression dressing for stabilization immediately after surgery, eliminating the need for internal fixation (pins, screws plates, etc.)  It is unnecessary to fuse the toe joints.  

The small surgical incisions enable the surgeon to use fine specially designed instruments to obtain the best cosmetic result.

Surgery is performed under Fluoroscopic imaging and using just local anesthetic instead of general anesthesia, makes foot surgery possible for some patients who were previously considered to be too at risk for traditional surgery due to age or medical history. 


There is less trauma to the tissue and surgical times are lessened with this technique, reducing pain and recovery time. Less suturing is necessary and often times no sutures are used. Postoperative patients ambulate immediately and are often placed temporally in a surgical shoe or boot to aid ambulation. 

The most commonly performed MIS procedure for hammertoe correction at the Coeur d’Alene Foot & Ankle Surgery Center is the Isham hammertoe correction procedure.