What is a curly toe you ask? It is just what it sounds like, a toe that bends over or under another toe and is present from birth. The condition is caused by a tight flexor tendon to the affected toe; however, the cause of the tight tendon is unknown. The 5th toe is most frequently affected, and curves under the 4th toe, but any toe can be involved. Toes can flex inward, outward or directly downward. In addition to just looking abnormal, the curved toe can result in pain as the child gets to an age where they begin to ambulate.
Symptoms can include painful callus formation, blisters, and painful rubbing of toes when wearing shoe gear. Children with severe curly toes can also have difficulty getting shoes to fit appropriately.
The condition does not typically worsen in degree of severity, but it does not always resolve spontaneously either.
Treatment can include stretching, taping and in cases of chronic pain, surgery. Passive stretching of the affected toe by the parent several times daily has been indicated for treatment, as well as taping the toe into a normal position by buddy taping to adjacent toe. These conservative measures unfortunately rarely result in resolution of condition. In children where a severe deformity is present, or the ambulating child is having pain, surgery can alleviate condition. Typically, surgery only requires a small incision in the bottom of the toe to release the contracted tendon and then splinting toe in a straight position.
Children with this condition should be evaluated by a podiatrist at a young age, because if the condition is deemed severe, earlier treatment results in better results as flexibility is greatest when children are very young.