Curly Toe – Information for Families

Nev Davies
Reading Childrens’s Orthopaedic Unit
Reading Foot & Ankle Unit

Information for Families – Curly Toes

curlytoe surgery

What are curly toes?

This common condition is usually present at birth but can become more noticeable when your child starts walking. It tends to occur in the third, fourth and fifth toes on one or both feet. The toes curl under because the tendons that flex (bend) them are too tight and pull the toe under the next toe, curling it towards the underside of the foot.

What are the symptoms of curly toes?

The main concern is the visible curling of the toe. In most people curly toes don’t cause too many problems. Sometimes, symptoms such as hard skin, rubbing, or pain can occur as well as problems getting shoes to fit.

What causes curly toes?

We do not know exactly what causes the tendon to be tight, but it has been noted that the condition can affect several generations, which implies that it is passed on from parent to child (inherited). Some patients have a toe bone that is more of a triangular shape than a rectangular shape which can also contribute to the cause.

What is the Natural History of this condition?

If the toes remain supple and flexible, they continue to be curly but do not cause a problem. Sometimes a curly toe can become fixed as the joint capsule also becomes tighter, but there is no evidence to show this causes more problems in later life.

How can it be treated?

Stretching – In the first instance we always recommend stretching out curly toes to keep them supple. This can be done daily as part of a bedtime or bath time routine. Some doctors and physiotherapists advise taping to the adjacent toes to hold the curly toe out straight but we feel this has limited value.

The most important point is to reassure you that curly toes usually do not cause a problem.

Surgery – In a small number of cases if the toes are causing significant trouble such as ongoing painful blisters or rubbing, we offer a small operation under a general anesthetic as a day case procedure. For more detailed Information on the operation – Please see our separate patient information leaflet.

Surgery for Curly Toes

Introduction

I offer this operation (a flexor tenotomy), to children with curly toes that cause problems and for whom nonoperative treatments have failed. (See general information leaflet on curly toes.) You will also have an opportunity to discuss any further concerns with me before we go ahead either in clinic or on the morning of the operation.

What does the operation involve?

The operation is performed as a day case under a general anaesthetic so your child will be asleep. (Please also watch this YouTube video to help you prepare.) The short procedure involves releasing the tight tendon causing the toe to curl through a small scar placed in the skin crease underneath the toe. We use dissolvable stitches covered by a non-sticky dressing and then wrap the foot in a crepe bandage (see picture right).

What are the success rates?

The operation is highly successful at relieving symptoms of redness, rubbing, blisters and toe tip pain. Depending on how flexible the curly toes are and despite releasing the tight tendon, some toes do remain curly. If there are ongoing symptoms or a recurrence of symptoms which are troublesome, then a more definitive procedure to fix the toe straight can be performed later.

Are there any risks?

As with all surgery there are small risks involved, which we will discuss with you fully before you sign the consent form. For this operation, the main risks are infection and nerve injury (causing numbness of the toe). Loss of the blood supply to the toe is extremely rare and not something I have experienced.

What is the aftercare?

It is important to elevate the foot on pillows for 72 hours after the operation to help the swelling settle and to aid healing. Crutches are useful but not essential to get around, particularly at school. I see patients at 2 weeks after the operation in clinic to check the healing. Sometimes physio is helpful to strengthen the foot, ankle and calf. I would anticipate a return to sports at 4 weeks.

Contact Form

    Your Name*

    Contact Email*

    Contact Number*

    Your Message

    Recent News

    Information for Families – Overriding 5th toe

    Nev Davies Reading Children’s Orthopaedic Unit What is an overriding 5th Toe? This uncommon condition is usually present at birth but can become more noticeable…

    Nev talking at the 2nd International Child and Adolescent Knee Congress

    Nev is delighted and honoured to have been invited to Talk at The 2nd International Child and Adolescent Knee Congress in Sheffield later this year….

    My Second ACL Reconstruction & High Tibial Osteotomy

    this article was originally posted on physiolabinfohub.com One of our patients, Mark Abbott, explains how a severe knee injury at the age of 18 resulted…

    Testimonials

    I had a knee arthroscopy to removed and clean up damaged cartilage after 6 years of repeated injury and dislocation from playing sport. I had been putting off the idea of surgery, but it was a great decision to finally get it seen to. I couldn't be happier with the results so far, and in less time than expected. Running, squats and climbing stair caused pain, and a lot more cracking than a 22 year old's knee should have! Now 2 weeks after the op, and following the physio exercises given after the operations, I am driving and climbing/ descending stairs without a problem and on the road to a full recover and hoping to get back to regular exercise within the next few weeks.

    I came to see you approximately four years ago and talked through the pros and cons of having an ACL replacement following an ACL rupture in my right knee I suffered playing an ill- advised game of beach volley ball on holiday in Antigua. I went ahead with the operation which you successfully performed at the Dunedin Hospital in Reading, I got on with my rehab and I now just wanted to let you to know that I will be running the London Marathon in three weeks (and raising money for Whizz-Kidz a disability charity for young people.) This letter is just a belated thank you for enabling this to happen.

    Mr Davies is a fantastic surgeon he put in a half knee joint in my right knee I have no problem with it ever since the operation in August last year. I have no more pain in my knee at all. I would recommend him to anyone.

    Mr Nev Davies has a very pleasant manner and was easy to talk to. The service provided was efficient, quickly identified the problems I had and was able to recommend treatment close to where I live.

    Memberships

    • General Medical Council (GMC) Membership
    • Royal College of Surgeons of England (RCS(Eng.))
    • British Medical Association (BMA)
    • British Orthopaedic Association (BOA)
    • British Society of Children's Orthopaedic Surgery (BSCOS)
    • British Association of Surgery of the Knee (BASK)
    • AO European Trauma Group
    • British Orthopaedic Sports Trauma and Arthroscopy Association (BOSTAA)