Adductovarus Deformity of the 4th or 5th Toe…

Recently, a concerned parent requested advice on her daughters “curly toes which appear to run in the family”.

The child presented with a flexible, rotated 5th toe (a crooked toe that tries to move under the adjacent toe). There was no reported painful symptoms or changes to the skin.

The cause of this rotation was an overpowering imbalance in the tendons attached to the the bottom of the toes.

Most people we see in clinic with digital deformities report varying degrees of pain or they can be asymptomatic. They may report a history of deformity from birth or early childhood and may be either congenital or acquired. Interestingly, the incidence of digital deformities appear greater amongst females than males in almost all age groups.

As mentioned the child at present was asymptomatic, although over time the little toe may rub against the side of a shoe causing painful corns and callus to form. The nail may also become thickened from pressure.

So, to prevent future painful issues it was advised to find a reputable shoe fitter to ensure the right width and depth of shoe is worn. (Happy to report she was a customer of One Small Step Buxton ). Wearing the right shoe actually decreases shoe pressure over bony prominences.

Furthermore, we advise she opt for a shoe with a fastening to hold the foot in place; this relaxes the toes, prevents them clawing in the shoe and subsequent friction and pressure to the digits.

It was a real treat to have the energetic little girl in clinic and reassure Mum she was doing everything right.