Your child may have been born with curly toe, which describes a toe with a flexion contracture, which
causes the toe to flex and bend under the adjacent toe. The deformity is characterized by flexion and medial deviation of the proximal joint of the toe and lateral rotation of the distal joint. The cause is congenital tightness of the flexor tendons. The second and third toes are the most common toes that curl, with the pinky toe being the least common.
It is uncommon for curly toe to cause problems. 25% of toes resolve by the child's first birthday. Some toes will spontaneously resolve by the age of six. There is often a family history of curly toe, consistent with autosomal dominant transmission.
Some children will have pressure between the toes, which can cause pressure sores or blisters. The adjacent toe may develop corns because of pressure from the other toe. Shoes with extra padding or space will be required. If the child continues to have skin problems, a simple procedure is available to improve the toe position.
Diagnosis is made by physical examination. Curly toes are typically present bilaterally and x-rays will often be used to rule out other deformities and abnormalities.
Treatment sometimes involves taping of the toe, but the deformity usually recurs once the taping is taken off. Surgery is recommended for children over the age of 6 who have a persistent deformity. A simple open flexor tenotomy leads to relief of symptoms and does not lead to hyperextension.
If you believe have a foot problem and do not currently see a podiatrist, call one of our six locations to make an appointment.
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