Prevalence and Characteristics of Hammertoe Deformity
Description
Introduction: Hammertoe deformity is a common podiatric condition, yet standardized diagnostic criteria remain poorly defined. Prior research has described its clinical presentation, but little is known about the utility of radiographic parameters. This study examines the relationship between radiographic findings and symptomatic hammertoe deformity to refine diagnostic criteria and support clinical management.
Methods: A retrospective review of 1,000 foot radiographs from the Des Moines University Foot & Ankle Clinic was conducted. Inclusion required adequate imaging; patients with prior forefoot surgery were excluded. Radiographic measurements included Meary’s angle, Cobb’s angle, calcaneal inclination, second proximal-to-distal phalanx angle, and dorsal second metatarsal-to-proximal phalanx angle. Two podiatric students independently obtained measurements, blinded to each other, and averaged values were recorded. Patient age, hammer toe diagnosis, musculoskeletal disorder diagnosis, and diabetes status were also collected. Correlations were assessed statistically.
Results: Interim analysis of 300 radiographs excluded 8% of patients due to non-weight-bearing images, Charcot-Marie-Tooth disease, non-lateral views, age under 18, or prior forefoot amputation. Mean age was 64.45 years. Of the cohort, 5.3% had prior hammer toe, 12.3% diabetes, 6.3% neuromuscular disorder, and 3% hallux abducto valgus. Preliminary radiographic averages were: calcaneal inclination 15°, Meary’s angle -2.25°, second metatarsal dorsal cortex angle 152.45°, second proximal phalanx angle 92.63°, weight-bearing surface to proximal phalanx 13.7°, hallux abductus angle 14.2°, and first intermetatarsal angle 8.45°.
Discussion: Preliminary data suggest mild pes planus, borderline hallux valgus, and markedly abnormal second proximal phalanx angles, consistent with classic hammertoe findings. Ongoing analysis aims to establish a standardized radiographic classification for diagnosis.
Citation Information
Smith, Ashlyn; Fahy, Jillian; and Johnstone, Mathew, "Prevalence and Characteristics of Hammertoe Deformity" (2026). Office of Research DMU Research Symposium. 28.
https://digitalcommons.dmu.edu/researchsymposium/2025rs/2025abstracts/28
Prevalence and Characteristics of Hammertoe Deformity
Introduction: Hammertoe deformity is a common podiatric condition, yet standardized diagnostic criteria remain poorly defined. Prior research has described its clinical presentation, but little is known about the utility of radiographic parameters. This study examines the relationship between radiographic findings and symptomatic hammertoe deformity to refine diagnostic criteria and support clinical management.
Methods: A retrospective review of 1,000 foot radiographs from the Des Moines University Foot & Ankle Clinic was conducted. Inclusion required adequate imaging; patients with prior forefoot surgery were excluded. Radiographic measurements included Meary’s angle, Cobb’s angle, calcaneal inclination, second proximal-to-distal phalanx angle, and dorsal second metatarsal-to-proximal phalanx angle. Two podiatric students independently obtained measurements, blinded to each other, and averaged values were recorded. Patient age, hammer toe diagnosis, musculoskeletal disorder diagnosis, and diabetes status were also collected. Correlations were assessed statistically.
Results: Interim analysis of 300 radiographs excluded 8% of patients due to non-weight-bearing images, Charcot-Marie-Tooth disease, non-lateral views, age under 18, or prior forefoot amputation. Mean age was 64.45 years. Of the cohort, 5.3% had prior hammer toe, 12.3% diabetes, 6.3% neuromuscular disorder, and 3% hallux abducto valgus. Preliminary radiographic averages were: calcaneal inclination 15°, Meary’s angle -2.25°, second metatarsal dorsal cortex angle 152.45°, second proximal phalanx angle 92.63°, weight-bearing surface to proximal phalanx 13.7°, hallux abductus angle 14.2°, and first intermetatarsal angle 8.45°.
Discussion: Preliminary data suggest mild pes planus, borderline hallux valgus, and markedly abnormal second proximal phalanx angles, consistent with classic hammertoe findings. Ongoing analysis aims to establish a standardized radiographic classification for diagnosis.
