Seattle Foot Surgery & Forefoot Reconstruction

Forefoot surgery, trauma care, deformity correction, and limb-preservation procedures

When conservative care no longer relieves pain, choosing the right foot specialist matters. Dr. J. John Hoy is a board-certified foot surgeon and podiatric physician with more than 25 years of experience in forefoot reconstruction, foot trauma, sports medicine, biomechanics, diabetic limb preservation, and complex foot pathology.

He performs both in-office procedures and hospital-based surgery for conditions ranging from bunions and hammertoes to fractures, Charcot deformity, infections, and limb-threatening diabetic foot complications. His surgical expertise focuses primarily on forefoot reconstruction, including bunion surgery, hammertoe surgery, neuroma surgery, hallux rigidus surgery, metatarsal surgery, tendon repair, and diabetic limb preservation.

In pain? Don’t wait. Early treatment leads to faster recovery. Urgent appointments available. Schedule now or call: 206-682-8741.

Forefoot Reconstruction Built on Biomechanics

At Seattle Foot and Ankle Center, Dr. John Hoy provides advanced surgical care focused on forefoot reconstruction, foot deformity correction, trauma, and limb preservation, including bunions, hammertoes, neuromas, and hallux rigidus.

Dr. Hoy’s surgical philosophy is rooted in the principle that foot surgery and biomechanics are inseparable. He trained at the California College of Podiatric Medicine (CCPM), one of the historic centers of modern podiatric biomechanics and orthotic science, where biomechanics and surgery were integrated into a single academic department. This foundation allows treatment to begin with structural analysis and conservative correction, with surgery reserved when necessary.

Forefoot reconstruction requires specialized understanding of weight-bearing mechanics, deformity correction, joint preservation, and postoperative function. Dr. Hoy’s approach is grounded in the principles that helped shape modern podiatric forefoot surgery: respect for biomechanics, thoughtful correction, and procedures chosen for durable long-term outcomes.

Board-Certified Foot Surgery You Can Trust

Dr. Hoy is Board Certified in Foot Surgery by the American Board of Foot and Ankle Surgery (ABFAS).

He is also a Fellow of the American College of Foot and Ankle Surgeons (ACFAS) — a professional society dedicated exclusively to advancing foot and ankle surgical standards.

In addition to surgical certification, Dr. Hoy maintains board certification in non-surgical podiatric medicine, giving patients the advantage of dual expertise:

• Conservative care first
• Surgery only when appropriate
• Precise surgical technique
• Structured, weight-bearing recovery plans

The foot and ankle are an anatomic region, and podiatry is the specialty dedicated to that region. A foot and ankle physician can first evaluate the problem, establish the diagnosis, and determine the appropriate course of care. When additional expertise is needed, that care can be coordinated as part of the treatment plan.

Forefoot surgery has a long and important history within American podiatric medicine. Podiatric surgeons have helped pioneer many of the foundational techniques used today for bunion correction, hammertoe repair, forefoot reconstruction, and diabetic limb preservation. Leaders such as Dr. E. Dalton McGlamry helped establish many of the surgical principles that continue to guide foot surgery today. Dr. Hoy completed much of his surgical training in San Diego under surgeons whose training lineage traces directly back to McGlamry, helping shape his approach to forefoot reconstruction, biomechanics, and long-term functional outcomes.

A Surgical Specialty With Deep Roots

American podiatric physicians have been developing and performing foot surgery for more than a century. The profession awarded the Doctor of Surgical Chiropody (D.S.C.) degree as early as the first half of the 20th century, and in 1942, surgeons within the profession founded the American College of Foot Surgeons, now the American College of Foot and Ankle Surgeons (ACFAS). Over the decades that followed, podiatric surgery developed formal surgical standards, hospital-based training, residency programs, and increasingly comprehensive treatment of the foot and ankle.

Today, podiatric physicians complete four years of podiatric medical school followed by postgraduate residency training in podiatric medicine and surgery. Foot and ankle surgeons who pursue surgical board certification undergo additional rigorous examination and case-review requirements through the American Board of Foot and Ankle Surgery (ABFAS). Surgery has therefore been an established part of American podiatric medicine for generations.

Learn more about the advantages of choosing a podiatrist with dual board certification.

“Dr. Hoy is extremely conscientious and provides many treatment options. My surgery ended up with increased range of motion and less pain in my foot.” – Debra

Forefoot Surgery Specialist in Seattle

Forefoot deformities are among the most common causes of chronic foot pain. They require detailed understanding of biomechanics, alignment, and long-term joint preservation.

Bunion Surgery (Hallux Valgus Repair)

Bunions can cause:

• Progressive deformity
• Joint pain and stiffness
• Shoe-fitting problems
• Overlapping toes

Dr. Hoy performs corrective bunion procedures tailored to the severity of deformity — from osteotomies to joint-preserving techniques and fusions when necessary.

Hammertoe & Clawtoe Surgery

Painful, contracted toes may require:

• Tendon balancing
• Joint realignment
• Fusion for severe deformity
• Temporary pin or implant stabilization

Procedures may also include metatarsal osteotomies to redistribute pressure and relieve pain in the ball of the foot. Surgical correction improves comfort, alignment, and long-term shoe wear.

Hallux Rigidus (Big Toe Arthritis)

When stiffness and arthritis limit motion in the big toe joint, options may include:

• Bone spur removal (cheilectomy)
• Joint preservation procedures
• Corrective fusion for end-stage arthritis

Surgery is chosen based on joint condition, activity level, and long-term goals.

Tailor’s Bunions (Bunionette Deformity)

Painful prominence on the outside of the foot can make shoe wear difficult. Surgical realignment restores balance and reduces lateral foot pain.

Neuroma Surgery (Morton’s Neuroma)

Burning, tingling, or numbness between the toes may indicate a neuroma. When injections and orthotics fail, surgical excision can relieve pain, with typically shorter recovery than bone procedures.

Surgeries for Injuries and Limb Preservation

These are urgent surgeries performed to preserve function and structure of the foot.

Limb Preservation & Infection Surgery

• diabetic foot infections
• gangrene
• abscess drainage
• bone infection surgery
• digital amputations
• ray resections
• transmetatarsal amputations
• ulcer-related exostectomy
• Charcot prominence reduction

Forefoot Injury & Sports Surgery

• sports-related forefoot injuries
• turf toe injuries
• simple tendon repair
• tendon lacerations
• forefoot reconstruction
• open reduction internal fixation of toes and metatarsals
• forefoot trauma

Forefoot Reconstruction Surgery

Forefoot reconstruction may involve bunion correction, hammertoe correction, metatarsal osteotomies, tendon balancing, neuroma excision, and joint-preserving procedures to restore alignment, reduce pain, and improve function.

Foot Surgeries Performed by Dr. Hoy

Some of the most common in-hospital reconstructive surgeries Dr. Hoy performs are for the following conditions:

• Bunions
• Hammertoes and clawtoe deformities
• Forefoot arthritis, such as hallux rigidus or limitus
• Tendon repair
• Plantar fasciitis
• Bone spurs
• Bone infections
• Foot fractures
• Soft tissue masses, deep

Some of the common surgeries Dr. Hoy performs includes:

• Bunion surgery/hallux valgus repair
• Hammertoe/clawtoe and toe deformity surgery
• Forefoot tendon repair and tendon balancing procedures
• Hallux limitus/rigidus surgery
• Joint repair and fusions of foot joints to address arthritis
• Osteotomies, to improve alignment and prevent worsening deformities or arthritis
• Bone spur removal
• Metatarsal surgery to improve alignment and reduce forefoot pressure
• Reconstructive surgery
• Neuroma excision surgery
• Pediatric surgery
• Trauma surgery, including foot fracture repair and dislocation repair
• Soft tissue mass excision
• Management of infection/limb salvage surgery
• Tendon lengthening/transfer
• Tenotomy
• Capsular release
• Corrective fusion
• Charcot foot stabillization and limb preservation

Read for more information about hospital surgeries here:

Bunion Surgery: There are many different types of bunion surgery depending on the severity of the bunion and the joint involvement.  Dr. Hoy can explain the bunion procedure that is most appropriate for your bunion.  Depending on the surgical procedure, the recovery time can be very different—particularly if you need to be on crutches after the surgery or in a cast.

Fusions: Fusions are usually performed to treat arthritic or painful conditions of the foot.  A fusion involves removing all cartilage from a joint and then joining two or more bones together so that they do not move.  Fusions can be done with screws, plates, or pins, or a combination of these.

Hammer Toe Surgery: Hammer toe surgery may involve removing a portion of one of the bones in the toe to realign the toe or could involve fusing the joints in the toe (see Fusions, above).  In some cases, it may involve placing a temporary wire to hold the toes straight or a permanent implant in the toe to maintain realignment.

Heel Spur Surgery: Based on the condition and the nature of the disease, heel surgery can provide relief of pain and restore mobility in many cases.  The type of procedure is based on examination and usually consists of plantar fascia release, with or without heel spur excision.  There have been various modifications and surgical enhancements regarding surgery of the heel.  Dr. Hoy will determine which method is best suited for you.

Metatarsal Surgery: Surgery on the long bones of the feet behind the second, third, fourth, and fifth toes is performed for a variety of reasons but is commonly performed to redistribute the weight bearing on the ball of the foot.  In some severe cases, such as rheumatoid arthritis, surgery may involve removing the metatarsal heads (the bones in the ball of the foot area).

Neuroma Surgery: Neuroma surgery involves removing a benign enlargement of a nerve, which may be causing tingling/burning/numbness to certain toes, usually between the metatarsal heads in the ball of the foot.  This soft tissue surgery tends to have a shorter recovery time than bone procedures, but it leaves some residual numbness related to the removal of the piece of nerve tissue.

Foot Reconstructive Surgery: Advanced procedures may include tendon balancing, joint stabilization, and corrective fusion to restore alignment and address long-standing deformities. Reconstructive surgery of the foot consists of complex surgical repair(s) that may be necessary to regain function or stability, reduce pain, and/or prevent further deformity or disease.  Unfortunately, there are many conditions or diseases that range from trauma to congenital defects that necessitate surgery of the foot.  Reconstructive surgery in many of these cases may require any of the following: tendon repair/transfer, fusion of bone, joint implantation, bone grafting, skin or soft tissue repair, tumor excision, amputation, and/or the osteotomy of bone (cutting of bones in a precise fashion).  Bone screws, pins, wires, staples, and other fixation devices (both internal and external), and casts may be utilized to stabilize and repair bone in reconstructive procedures. These techniques are used to correct the underlying structural problems causing pain, instability, or progressive deformity.

Forefoot Tendon Surgery: Surgery on the tendons can be performed for acute injuries such as ruptures and can also be performed for chronic conditions to lengthen or shorten the tendon, depending on the problem. 

Charcot Foot Surgery: Dr. Hoy performs limb preservation, exostectomy, wound management, and selective stabilization. Charcot foot can lead to collapse, ulceration, bony prominence, instability, and infection. Dr. Hoy provides selective surgical treatment focused on limb preservation, including exostectomy (removal of bony prominences), wound management, infection control, and stabilization when appropriate. For severe Charcot deformities requiring complex reconstruction with external fixation, referral to specialized tertiary centers may be recommended.

Specialized Foot & Ankle Surgical Care

Musculoskeletal conditions of the foot and ankle have long been part of comprehensive podiatric medicine. Podiatrists diagnose and treat these conditions using both conservative and surgical approaches. Dr. Hoy’s practice focuses exclusively on disorders of the foot and ankle, including forefoot reconstruction, biomechanics, sports injuries, tendon pathology, diabetic limb preservation, and reconstructive surgery. This focused specialty training allows for detailed evaluation of weight-bearing function, deformity correction, and long-term mobility outcomes.

Read about: What Is the Difference Between a Podiatrist and an Orthopedic Foot Surgeon?

Surgery Only When It’s the Right Decision

At Seattle Foot and Ankle Center, surgery is never the first step unless necessary. The best outcome is our first priority. Surgery is considered within the context of a comprehensive evaluation of the foot and ankle—not as an automatic destination. A referral for evaluation does not presume surgery; it allows the diagnosis and the full range of appropriate treatment options to be considered first.

A robust array of non-surgical options, such as:

• Extracorporeal shockwave therapy
• Custom orthotics
• Bracing
• Rehabilitation
• Medication and injection therapy

are used as first-line treatment to resolve your foot or ankle condition.

“I contacted Dr. Hoy just a few days before a major surgery for my left foot to get his insight/second opinion and his guidance saved me from quite a major recovery/financial burden. After suffering from a 10 month long miserable foot issue, Dr. Hoy suggested essential changes to my self treatment and I’m now nearly at a full recovery ~6 weeks later.” -Austin H.

Sometimes foot and ankle conditions do not resolve with non-surgical care, may benefit from early surgical intervention, or require urgent surgery, such as in the case of infections and injuries. When pain or deformity persists, surgery may be appropriate to alleviate discomfort or restore function. Dr. Hoy can determine when surgical intervention may be helpful.

Surgery is considered only after the diagnosis, severity of the condition, functional impact, and available non-surgical options have been evaluated. For patients who have been told they need surgery, an independent foot and ankle evaluation can also help clarify whether surgery is appropriate and what alternatives may exist.

Dr. Hoy’s surgical philosophy is grounded in proven principles of deformity correction, biomechanics, tissue preservation, and long-term function. He believes surgery should be based on sound judgment, established techniques, and what offers the highest likelihood of success—not novelty, unnecessary complexity, or trends that have not yet stood the test of time.

When appropriate, Dr. Hoy will also refer patients to other centers of excellence in the Seattle area for procedures outside his specific training or expertise. When a condition requires highly specialized rearfoot reconstruction, advanced ankle stabilization, or complex external fixation, Dr. Hoy coordinates referral to trusted surgical centers while continuing to provide diagnosis, conservative care, second opinions, and postoperative co-management. Dr. Hoy provides expert diagnosis, conservative management, second opinions, and referral coordination when advanced surgical care is needed. This ensures you have access to the full spectrum of surgical options and the best possible care for your condition.

Surgical Judgment Matters

Good surgery is not about doing the biggest procedure—it is about doing the right procedure. Some conditions benefit from early intervention, while others improve without surgery. Knowing the difference is one of the most important parts of surgical care.

Hospital & Surgical Center Privileges

Dr. Hoy performs outpatient and hospital-based surgery within the Swedish Medical Center system, including:

• Ballard Hospital
• Redmond Ambulatory Surgery Center

This allows access to high-quality operating facilities and coordinated perioperative care.

What to Expect

Understanding Your Condition and Treatment Options

Full understanding of your condition and options allows you to make informed decisions about your care. During your initial visit, we will evaluate your condition and discuss all possible treatment options. This appointment also allows us to review your goals and expectations, which is especially important for patients with severe deformities or advanced-stage disease.

If surgery is recommended, Dr. Hoy will explain the procedure in detail, including what the surgery involves, as well as the potential risks, benefits, and recovery process. If operating room surgery is indicated, we will review the procedure and obtain X-rays if necessary. A formal surgical consultation, including signing consent forms, will take place at a follow-up visit.

Dr. Hoy will also coordinate with your primary care physician to ensure you are medically ready for surgery. Throughout the perioperative period, he will guide you through each step of the process, answer your questions, and support your recovery with the goal of improving mobility and helping you return to your normal activities.

“I have had 2 separate foot surgeries through Dr Hoy, and both times I felt very comfortable with the procedures Dr Hoy recommended. He is knowledgeable in is field, and takes time to listens to his patient’s concerns. I would highly recommend him for your foot needs!” – Mary T.

Preoperative Testing and Care

As with any surgical procedure, patients undergoing foot or ankle surgery may require certain tests or examinations beforehand to help ensure the best possible outcome.

Before surgery, Dr. Hoy will review your complete medical history and current health conditions. This includes evaluating any illnesses, allergies, and medications you are currently taking. Additional tests may be ordered to assess your overall health, such as:

• Blood tests
• Urinalysis
• Electrocardiogram (EKG)
• X-rays
• Blood flow studies to evaluate circulation in the feet and legs
• An examination of your foot structure and walking pattern

Depending on the results of these tests or your specific medical conditions, a consultation with another medical specialist may also be recommended.

Postoperative Care

The type of foot or ankle surgery performed will determine the length and type of care required during recovery. Most postoperative care includes some combination of the following:

• Rest
• Ice
• Compression
• Elevation

You may also need supportive devices such as bandages, splints, surgical shoes, casts, crutches, or canes to protect your foot and ensure a safe recovery.

Dr. Hoy will advise you on when it is safe to begin putting weight on your foot after surgery. His goal is to help you achieve a smooth and timely recovery. Carefully following the postoperative instructions provided before and after surgery will help ensure the best possible outcome.

Understanding Your Foot or Ankle Surgery

In-Office Surgical Procedures

Many foot conditions can be treated safely in the office using local anesthesia, avoiding the need for hospital-based surgery. These procedures are performed when medically necessary to relieve pain, treat infection, or prevent complications.

• Treatment of ingrown toenails and painful nail conditions (when medically indicated)
• Wart removal and skin lesion treatment, including biopsy when needed
• Callus and pressure lesion care to relieve pain and help prevent ulcers
• Minor soft tissue procedures performed safely in-office

Dr. Hoy performs in-office surgeries, such as for:

• Thick or fungal toenails
• Retronychia
• Dark lines on nails
• Toenail trauma
• Painful corns or calluses
• Ulcers and wounds
• Corticosteroid injections
• Ingrown toenails
• Foreign bodies
• Infections
• Biopsies for skin lesions
• Warts
• Soft tissue masses, superficial
• Tenotomies

A new patient visit is required to identify the condition and discuss all treatment options. If office surgery is indicated, informed consent is obtained along with a discussion of postoperative instructions. Elective procedures requiring anesthesia will be performed on the next visit.  Dr. Hoy wants you to have a satisfactory and speedy recovery, and this outcome can be achieved by carefully following the postoperative instructions that you have discussed prior to and immediately after surgery.  Our patients can expect a successful result with a smooth recovery with in-office surgeries.

Read below for more information about specific in-office surgeries:

Nail Surgery: Toenails can become deformed, damaged, or infected. It may be determined that the best treatment may involve surgery.  Surgery is typically performed in the office under local anesthetic, and many patients can walk out and return to activities.  Surgery involves either partial or total removal of the nail. An avulsion is a non-permanent type of surgery that allows relief, but the nail will grow back.  A matrixectomy is a permanent type of surgery, which involves destroying and/or removing the nail root so that no new nail grows.  Other nail procedures include subungual hematoma evacuation; nail biopsy/excision.

Skin Surgery: Lipomas, fibromas, warts, moles, and rashes can occur on any part of the foot skin surface.  Some of these conditions can be painful and impact function. In other cases, they can be questionable because they are new in appearance and a biopsy may be recommended. These skin conditions may or may not be painful.  Depending on the size and depth of the condition, surgery may be performed in the office under local anesthesia or take place in the operating room.  Procedures we perform include debridement of ulcers and hyperkeratoses, wart treatment, corn/callus care, soft-tissue mass excision.

When Every Step Hurts — It May Be Time for a Surgical Consultation

When every step hurts and nothing has worked yet, it may be time to consider a surgical solution.

If you are searching for:

• Seattle bunion surgeon
• Hammertoe surgery Seattle
• Hallux rigidus surgery Seattle
• Neuroma removal Seattle
• Forefoot reconstruction specialist

You deserve a surgeon who focuses on the foot — every day.

“Seattle Foot and Ankle Center – I cannot say enough good things about this practice!  Dr. Hoy was kind, professional, and took the time to explain everything clearly so I always knew what to expect, including clearly outlining all of my options. And I can’t forget, Jessica (front of the office) who is equally amazing, professional and patient. The entire team made the process (I opted for surgery) smooth and stress-free. From start to finish, the communication was excellent, and I felt well cared for at every step. Highly recommended for anyone looking for top-notch care and a team that truly values their patients.  Thank you Dr. Hoy!” – Rochelle J.

Frequently Asked Questions About Foot & Ankle Surgery in Seattle

Schedule a Surgical Consultation

At Seattle Foot and Ankle Center, Dr. John Hoy combines conservative judgment with advanced surgical precision.

If you are searching for:

• Seattle bunion surgeon
• Hammertoe surgery Seattle
• Hallux rigidus surgery Seattle
• Neuroma removal Seattle
• Forefoot reconstruction specialist

Call 206-682-8741 or schedule online to consult with Dr. John Hoy, a board-certified foot surgeon who prioritizes precision, safety, and long-term mobility.

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📞 Call today to schedule your consultation

Your mobility. Your comfort. Your future steps — done right.

In pain?  Don’t wait.  Early treatment leads to faster recovery.  Urgent appointments available.  Read about Conditions We Treat.  Request an Appointment 5am-5pm M-F or online.  Call: 206-682-8741 or Contact Us.  If you like our content, please link it to your website and Collaborate With Us.  Thank you.