Foot above the hot tub with a bunion and a floating toe that crossed over

Floating Toe After Hammertoe Surgery

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Hammertoe surgery, especially minimally invasive procedures, rarely lead to unpleasant complications. However, in some cases, things might not turn out the way we want them to – one of the possible complications can be a floating toe after hammertoe surgery. If you haven’t heard of this condition and you’re getting ready to schedule a hammertoe surgery, it would be best to take a look at this text – the more you know about the procedure and its complications, the better.

What Exactly Is Floating Toe?

Floating toe, also known as flail toe or elevated toe, is a common deformity of lesser toes. It essentially means that one of the toes isn’t aligned with the rest of them – it sticks up in the air and always remains lifted off the ground, even when the person places the foot flat on an even surface. This causes various problems.

Over time, the floating toe can even cross over the adjacent toe. The deformity usually occurs on the second toe. While it might seem like a benign condition, it actually causes plenty of pain and discomfort to the patient – it’s not something that can be left untreated. The main problem lies in the irregular force distribution and balance issues. 

Why does this condition develop? Post-operative complication after hammertoe surgery is only one of the reasons. Floating toe can occur due to bunion deformities, hallux limitus (big toe with a restricted range of motion), abnormally large second toe, or even trauma of the foot (however, this is a rare cause for the floating toe). It can also develop as a complication of a Weil osteotomy. These are all causes for floating toes in adults, but they can also develop in childhood – usually due to weakness of toe joints and muscles.  

What Are the Symptoms of Floating Toe?

So, what happens if you have a floating toe? As you might have expected, this condition isn’t painless – inflammation and pain are two of the most common symptoms related to floating toes. The skin of the toe is red (because of the inflammation), and the tissue under the metatarsal head of the toe can get thicker. The joint is unstable – it can become too rigid or too loose – a loose toe has a tendency to cross over the adjacent toe. This leads to even more pain and balance problems. 

Doctor examining the foot and holding an X-ray

What Is a Treatment for Floating Toe?

The treatment for the deformity can vary – you will have to talk to your podiatrist, who will decide on the best way to resolve the issue. However, there are two main options – non-surgical and surgical treatment. Non-surgical refers to physical therapy, which can help in some cases, but it won’t always be enough. If it doesn’t work, you will have to undergo a surgical procedure to fix the floating toe. 

The goal of the surgery will be to address the underlying issue that causes the floating toe. There are two main reasons why it develops – it’s either due to a long, weak flexor tendon or the bone which was shortened too much in the first surgery when fixing the hammertoe. So, your surgeon’s job will be to determine what’s the cause of a floating toe and then fix it to return the functionality of the toe to its original state. 

An important thing to keep in mind is that procedures for fixing the post-operative floating toe are a bit unpredictable. The problem lies in the size of a joint – it’s pretty small. Plus, if a patient had a floating toe for a long time before fixing it, there could be permanent damage to the soft tissue, which won’t allow the surgeon to return everything to its original state. Of course, this only goes for severe deformities, which just means that seeking treatment as soon as possible is the best thing you can do for yourself. 

How to Prevent the Post-Op Floating Toe?

As you can guess from the text above, preventing the post-op floating toe partially depends on your surgeon and their technique – if the hammertoe surgery was performed correctly, the chance of floating toe complications is lower. Of course, proper post-operative care is of huge importance as well. So, what can you do to help your chances of avoiding a floating toe after hammertoe surgery? 

  • Follow your surgeon’s instructions down to every detail – they were given for a reason,
  • Elevate the operated foot to help with the recovery,
  • Don’t skip on wearing the special shoes you were provided after the surgery – their goal is to prevent future deformities,
  • If your doctor recommends, go to physical therapy,
  • Avoid high heels and uncomfortable shoes. Give advantage to open-toe footwear or shoes with a wide toe box.

Contact Your Surgeon for All Information About Floating Toe After Hammertoe Surgery

If you happen to have a floating toe, we recommend contacting us for a consultation. Our team at Luxe Foot Surgery clinic will examine your foot and explain what can be done to fix the deformity. Dr Lopez DPM is extremely skilled and experienced. You can contact us via an inquiry form or call our office from Monday to Thursday: 9 AM to 6 PM and on Friday from 9 AM to 5 PM.  


How Do You Fix a Floating Toe?

A floating toe can be fixed either with physical therapy (although this is rare) or with a surgical procedure that would address the underlying issue – that can be a long-weak flexor tendon or a bone that was shortened too much during the previous surgery. 

Is a Floating Toe a Problem?

Yes, a floating toe is a medical problem. It often causes pain and inflammation that prevent a patient from performing their everyday activities. The toe can also cross over to the adjacent toe, leading to further issues. Floating toes should always be addressed as soon as diagnosed. Early treatment ensures better results.


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