(This is a page in progress where I hope to add more cases when I get the opportunity)
Curly toes correction
Often present in infants with parents concerned about an over-riding toe. However, the mechanism of the deformity is that one or more of the toes is under-riding due to a flexion contracture. The flexed toe usually casuses the neighboring toe to over-ride. The flexion deformity sually affects the 3rd and 4th toes. In the vast majority of cases, there is no impact on function. Cosmesis in later life is often the main parental concern. A simple division of the tendon through a small incision in the flexion crease of the toe improves the alignment and appearence. However, parents must be counselled about the possibility of recurrence. Occasionally in older children I may supplement it with K wire stabilisation of the toe for a few weeks to stretch out the tendons and limit the risk of recurrence.
Lesser toe deformity correction
If the deformity in a lesser toe is stiff then dividing the flexor tendon alone is insufficient to correct the deformity. Usually the issue presents in older children close to being fully grown. If sufficiently problematic to the patient, the most predictable outcome favours fusing the toe into a straight position. Often I will point my teenage patients in the direction of my adult foot and ankle colleagues who see and do a lot more of this type of surgery.