Do I have to a wire sticking out my toe?

• Not necessarily

• Lesser toe deformity correction (hammer, mallet, claw) is almost universally treated with a wire passed through the bone and sticking out of the end of the toe

• Similar to a Kebab!

• The wire is bent and cut and dressed to avoid injury.

• It works very well and is extremely cost affective

• Complications include wire problems, wire infections around the skin entry point and rarely deep bony infection.

• Mr Gary Hannant is able to offer an alternative to Self Pay Patients and other patients who are high risk of infection patients only currently (Jan 2026)

  • This would be immunocompromised patients only

• A small device not much bigger than a paracetamol capsule can be placed inside the canal of the bone and compress and hold the bone to allow fusion.

Big toe replacements

• The Gold standard for big toe (MTPJ arthritis) has long been MTPJ fusion.

• It is the most common operation Mr Gary Hannant performs for big toe arthritis.

• Replacement Surgery maybe a suitable options for you.

• Mr Gary Hannant performs Silastic MTPJ replacements in suitable patients

• The British Orthopaedic Foot and Ankle Society has a good patient information section if you are considering big toe arthritis surgery. Click here

Ankle Replacements

• Total Ankle replacements (TAR) are available at the Yorkshire Clinic

• They are performed as dual surgeon procedures by Mr Gary Hannant and Mr Kandasamy Sampathkumar

• This is common practice and is a key component of the Getting It Right First Time (GIRFT) principle and is how TARs are also performed at BRI.

• Total Ankle replacement may be a suitable option for your ankle arthritis and Mr Gary Hannant and Mr Kandasamy Sampathkumar are happy to help you explore this in clinic.

• The British Orthopaedic Foot and Ankle Society has an excellent resource you may want to read before visiting either of us. Click here

• Currently (as of Jan 2026) TARS are only available at the Yorkshire Clinic for Self Pay and Insured patients

Training day

Part of being a consultant is staying up to date and seeking out solutions to difficult to treat problems. A day spent in a Cadaveric Lab is the perfect learning environment. Here I was seeking out knowledge on Hammer toe devices to replace Wires sticking out the ends of toes. Whilst the wires work very well, for high risk infection patients such as those on drugs for Rheumatoid Arthritis it is not ideal. An intra-medullary (inside the bone) device offers one way to reduce the risk. Silicon big toe (MTPJ) replacements and lesser toe MTPJ replacements are also potential solutions to arthritis where movement is required. Finally the IOFIX device is an excellent device for fusion surgery where a strong hold and early weight bearing is required. I have utilised it regularly for Talo-Navicular arthritis and and the opportunity to compare tips and tricks with others for it’s use there and other joints was very welcome.