Hammer toe: Causes and Treatments

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376580/#:~:text=In%20a%20significantly%20larger%20series,and%2037%25%20within%205%20years


This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.

hammer toe
Image Credits: Footfiles 

“Take a few minutes each and every day to ensure that your mind is nourished properly and positively. After all, a healthy mind leads to a happier view of life and with a happier view of life it is much easier to counter the negative impact other issues will have on us.” – Catherine Pulsifer

A hammer toe is classified as a  deformity of the second, third or fourth toes. It is an orthopaedic condition that is created by wearing shoes that are too narrow for the feet. The feet adjust to their environment, by causing a realignment of the toes, in order to alleviate the stresses that are induced by the shoes.

How do shoes impact the formation of hammer toes? 

With the variety of shoes that exist on the market, there are predominantly two types of shoes that are available: those that will hurt your feet, and those that will not. Hammer toes are formed via the wearing of incorrectly sized shoes for the feet. Over time, the toes will have a bend at the middle joint. The angular shape created by the toe, creates a shape much like a hammer. 

Protecting your feet is critical, as hammertoes are actually painful, and over time the muscles, tendons and ligaments will be distorted as the toes are bent out of shape. When they are first formed, hammertoes are actually flexible, and as the shoe conditions persist, the toes eventually remain in their position. During the advanced stages of hammer toe, surgical intervention will be required in order to restore the toes to their original state. Hammer toe patients often experience: 

  1. Pain in the toes. As the soft tissue distorts, movement will induce pain. 
  2. Corns and calluses due to the fact that the toes are rubbing against the shoes due to the projections. 
  3. Open sores on the toes 

Some root causes of hammertoes are:

Shoes: Tight shoes or high heels are constricting to the toes.

Gender: Women are more prone to hammertoes due to the fact that they are more prone to tight shoes or high heels. 

Injuries: During regular activities such as walking, a toe can be stubbed. Additionally, during sporting activities the feet are prone to impacts which can induce hammertoes. 

An orthopaedic consultation will determine the severity of your hammertoe condition, and determine the next phase of your treatment. Your orthopaedic surgeon will usually prescribe either minimally invasive surgery, or other simpler treatments. 

How are hammer toes treated?

Hammer toes are treated via non-surgical and surgical methods. Non-surgical methods include: 

  1. Toe exercises to flex the joint. Stretch the toes to ensure that the joint is being exposed to both stretches and contractions. 
  2. Changing your shoes from those that are tight and constricted to those that are roomier.
  3. Shoe inserts to facilitate the re-alignment of the toes. 

If these methods aren’t effective, then minimally invasive surgical procedures can be recommended in order to treat the feet. Surgical treatments including methods such as arthroplasty, arthrodesis, tendon transfer, will help to realign the muscles,tendons,  and any bones that may be in the incorrect position. 

For all medical conditions including hammer toes, prevention is always better than cure. Critical actions you can take to maintain the health of your feet include: 

  1. Ensuring that you have the correctly fitting shoes.
  2. Since women are the most affected, it is best to seek comfort rather than cosmetic appearances. 
  3. Wearing flatter shoes or wedges instead of heels. 

Your health…is your wealth. Consult with your orthopaedic surgeon for a customized treatment plan.

Reference Article: 

  1. Medical News Today: https://www.medicalnewstoday.com/articles/315600.php
  2. Hammertoe: https://www.foothealthfacts.org/conditions/hammertoe
  3. OrthoInfo: Hammer Toe 

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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