Digiti Quinti Varus or curly toe syndrome is a condition that involves the toe bones of the foot. It most commonly presents in the 3rd, 4th or 5th toes and often affects the normal toe alignment of both feet. It is usually present from birth and causes the toe to either cross over or under the neighbouring toe or to be sat in a rotated position. As your child begins walking, the condition can become more noticeable and progress from a flexible deformity to a more rigid one.
The cause of this deformity is due to the contracture or shortening of the muscles within the foot, specifically the flexor digitorum longus and brevis muscles. These muscles control the movement of our toes and any imbalance of this muscle can result in deformity.
The shortening of these muscles is usually due to gripping of the toes on the floor or wearing certain footwear. The toes grip down to stabilise the foot, as a result, the small joints of the toe are put under excess strain and begin to deform.
Curly toes are often asymptomatic but in the long term can cause problems such as limiting footwear choices as a wider toe box is necessary to accommodate this deformity. If ill-fitting footwear like tight-fitting shoes are worn, excess pressure on the toe may lead to callus, corns or blisters developing. If the situation deteriorates, the integrity of the nail may be affected. This eventually can lead to deformity of the nail and an increased risk of fungal or other infections developing.
Children with curly toes can be treated with conservative methods such as customised insoles. Coupled with appropriate footwear, this can help to stabilise and support the child as they grow.
Adults with this condition will typically require surgical intervention to correct this condition.