What Is a Hammertoe?
A hammertoe occurs when the toe bends abnormally at the middle joint, typically due to muscular imbalance or structural deformities. Over time, this curling leads to pressure at the tip of the toe, friction against shoes, corns, calluses, and — in some cases — open sores.
Why Hammertoes Are Risky in Neuropathic Feet
For patients with diabetic peripheral neuropathy, sensation in the feet is reduced. This makes it hard to feel early warning signs like pressure, pain, or rubbing. As a result, hammertoes can silently cause wounds and ulcers, especially at the tip of the toe — a common site for complications that, if left untreated, may lead to infection or even amputation.
What Is a Flexor Tenotomy?
A flexor tenotomy is a minimally invasive surgical procedure that involves cutting the flexor tendon responsible for curling the toe. This small release allows the toe to straighten out, reducing the abnormal pressure and helping the toe rest more naturally.
Who Can Benefit?
✅ Patients with Diabetes or Neuropathy:
- Pre-ulcerative lesions or history of toe ulcers
- Rigid hammertoes causing tip pressure
- Calluses or corns on the toe tips
- High risk for complications from open wounds
✅ Non-Neuropathic Patients:
- Painful rigid or semi-rigid hammertoes
- Corns, shoe irritation, or difficulty fitting into footwear
- Wanting a minimally invasive alternative to joint fusion or arthroplasty
Whether you have diabetes or not, flexor tenotomy can offer relief and improved foot function, with less downtime compared to more invasive surgical options.
Key Benefits of Flexor Tenotomy
- Prevents toe-tip ulcers in high-risk patients
- Improves toe alignment and shoe comfort
- Minimally invasive — tiny incision, no hardware, and is done in-office
- Quick recovery — many patients walk the same day
- No stitches typically needed
What to Expect
The procedure typically takes 10–15 minutes per toe and is done with local anesthesia. Most patients can bear weight immediately in a surgical shoe and return to normal activities within days.
Final Thoughts
Flexor tenotomy is a simple, low-risk procedure with big benefits — whether you're looking to prevent a diabetic ulcer or just find relief from painful hammertoes.
Do you think you might be a candidate? Come visit me to see if flexor tenotomy is right for your feet.
Author
Blake Savage, DPM, MPH
Dr. Blake Savage, DPM, MPH is a podiatrist practicing at Orthopedic Foot & Ankle Institute in Henderson, Nevada. Dr. Savage has received extensive and comprehensive training in all aspects of foot and ankle surgery including reconstruction, limb salvage, trauma, and elective surgery. Having lived in various places across the country during his life, he is happy to now call Las Vegas his home.
Dr. Savage attended Brigham Young University in Provo, UT where he obtained a Bachelor of Arts in Russian. He went on to earn his medical degree from the College of Podiatric Medicine and Surgery at Des Moines University in Des Moines, IA. It was at Des Moines University where he pursued his interest in population health as well and concurrently received his Master of Public Health. He further completed a three-year surgical residency in St. Louis, MO before going on and finishing his advanced surgical fellowship training in Roanoke, VA.
