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Curly Toes and Overlapping Toes
Toes deformities are very common. Most of these deformities are very minor and a cosmetic problem. Some however cause pain and limitation of function or difficulty with fitting footwear. The deformities often present in childhood as curly or overlapping toes. These childhood deformities are often familial or genetic in their origin.
Later in life toes deformities may present for different reasons as Hallux Valgus or Hallux Rigidus. These conditions can also involve toes deformities including overriding toes. These conditions are considered in the relevant Orthopaedic100 information sheet.
This involves an upward and medial overlapping of the fifth small toes over the fourth. There may also be a rotation of the toes and contracture of the extensor tendon on the top of the toe. The condition is often familial and bilateral. The deformity often does not produce any symptoms but well fitting shoes may be a problem as well as the cosmetic appearance. A callus or hard painful area of skin can form on the top of the toes or on the outer lateral side called a bunionette.
Surgical correction of overlapping 5th toe may be achieved by surgery. This may be undertaken by release of the capsule, medial ligament and or by a skin flap correction of the toes. These procedures are known as the DuVries Correction or the Butler’s procedure. Both of these procedures usually provides good correction, rapid recovery and a high success rate.
This deformity causes a curling or flexion contracture of one or more toes. The toe may also be malrotated. The deformity is also known as a hammer toe. The deformity is often associated with a contracture of one or both of the tendons beneath the toes which cause the toe to bend or flex. The condition is often familial or genetic. It is commonly bilateral.
Curly toes may present with painful areas of hard skin or callosities under the tip of the toes on top where the toe may rub against shoes.
The treatment if necessary usually involves division of the deforming flexor tendon beneath the toe or in older children a core complicated transfer of the flexor tendon beneath the toe to on top of the toe to assist straightening of the toe. These procedures are known as a tenotomy or a Girdlestone procedure.
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