31 years
My 4 year old son's last two toes are twisted. He walks normally but sometimes he tells me that it's painful. An Osteopath said there was nothing abnormal. I feel it still deforms more. Any advice?
May 20, 2014
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Deformities of the toes are common in the pediatric age group. Generally a child is born with it (congenital), &it's familial. Many of these deformities can become worse with time & they rarely resolve on their own. During infancy and early childhood, symptoms are rarely reported; the complaints are due to cosmetic concerns. As the child grows up these deformities progress from flexible deformity to rigid, thus progressively producing symptoms. Common digital deformities of the 4th & 5th digits are underlaping toes &overlaping toes.
-Underlaping toes: The toes most often involved are the 4th &5th th toes. A special form of underlapping toes is called clinodactyly or congenital curly toes, which is common. The exact cause is unclear. A possible etiology is an imbalance in muscle strength of the small muscles of the foot. With weight bearing the deformity is increased &a folding or curling of the toes results in the formation of callus on the outside margin of the end of the toe. Tight fitting shoes can aggravate the condition. The age of the patient, degree of the deformity and symptoms determine treatment. If symptoms are minimal, a wait and see approach is advised. When treatment is indicated the degree of deformity determines the level of correction. When the deformity is flexible, a simple release of the tendon in the bottom of the toe will allow for straightening of the toe. If the deformity is rigid, removal of a small portion of the bone in the toe may be necessary.
-Overlaping Toes: characterized by 1 toe lying on top of an adjacent toe. The most common toe involved is the 5th toe. It is thought that it may be caused by the position of the fetus in the uterus. In infancy, passive stretching and adhesive tapping is used for 6 - 12 weeks with high rate of recurrence. As the individual matures the deformity becomes fixed. Eventually surgical correction will be required.
-Underlaping toes: The toes most often involved are the 4th &5th th toes. A special form of underlapping toes is called clinodactyly or congenital curly toes, which is common. The exact cause is unclear. A possible etiology is an imbalance in muscle strength of the small muscles of the foot. With weight bearing the deformity is increased &a folding or curling of the toes results in the formation of callus on the outside margin of the end of the toe. Tight fitting shoes can aggravate the condition. The age of the patient, degree of the deformity and symptoms determine treatment. If symptoms are minimal, a wait and see approach is advised. When treatment is indicated the degree of deformity determines the level of correction. When the deformity is flexible, a simple release of the tendon in the bottom of the toe will allow for straightening of the toe. If the deformity is rigid, removal of a small portion of the bone in the toe may be necessary.
-Overlaping Toes: characterized by 1 toe lying on top of an adjacent toe. The most common toe involved is the 5th toe. It is thought that it may be caused by the position of the fetus in the uterus. In infancy, passive stretching and adhesive tapping is used for 6 - 12 weeks with high rate of recurrence. As the individual matures the deformity becomes fixed. Eventually surgical correction will be required.
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