Priority 19 from the Foot Health PSP

UNCERTAINTY: What are the best ways to treat toe deformities (e.g. bunions, clawed toes, hammer toes)? (JLA PSP Priority 19)
Overall ranking 19
JLA question ID 0092/19
Explanatory note It is known that structural deformities of the toes have a high prevalence in the adult population (Sayli et al, 2018; Dunn et al, 2004),however research to support the most effective, non-surgical management strategies is limited and /or weak. Such deformities are associated with significant disability such as foot pain, balance issues and increased falls rates (especially in the elderly). Therefore research to understand the most effective non-surgical management strategies and the most effective time to instigate interventions is essential in reducing the potential risk of developing subsequent morbidity as a result of such deformity.  

CD007809 – Zammat et al (2010). Intervention for the treatment of osteoarthritis of the big toe. Only 1 trial of poor quality included, therefore limited to no conclusions about treatment. 

Health Research Classification System category Generic health relevance 
Extra information provided by this PSP
Original uncertainty examples What can I do to prevent bunions? ~ How are toes prevented from curling? ~ What is the best treatment for hammer toes?
Submitted by Healthcare Professional x 1, Patient x 12
PSP information
PSP unique ID 0092
PSP name Foot Health
Total number of uncertainties identified by this PSP. 30  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 26 September 2019