OWL: OCOSH Classification/Foot Deformities/Congenital Foot Deformities/Curly Toes

Curly Toes

Wulker at al — 2009-06-10 23:01:51 GMT

Section in An Atlas of Foot and Ankle Surgery By Nikolaus W�lker, Michael M. Stephens, Andrea Cracchiolo. Headings - Introduction, Treatment, Surgical technique - Flexor tenotomy; Tendon Transfer, Post-op care, Complications, Bibliography
Edition: 2, illustrated Published by Taylor & Francis, 2005 ISBN 1841841951, 9781841841953

Curly toes and overlapping toes Wheeless

Wheeless — 2007-10-23 23:01:51 GMT

Overlapping Toes: - involves an dorsal-adduction deformity of the 5th toe; - other components of the deformity include external rotation of the digit, contracture of the EDL tendon; - in some cases there may be dislocation of the MTP joint; - often the deformity is familial and bilateral;
Curly Toes: - involves malrotation of one or more toes along w/ digit flexion deformity; - in contrast, hammer toes are generally not mal-rotated; - may be due to contracture of FDL and FDB; - common disorder in children - look for symmetric deformity in the opposite foot

Curly Toes POSNA

Not Available — 2007-10-28 23:01:51 GMT

Core Curriculum
Objectives
1. Define curly toe
2. Discuss the natural history of curly toes
3. Discuss treatment of curly toes

Flexor tenotomy in the treatment of curly toes

Pollard & Morrison — 2009-06-10 23:01:51 GMT

J. P. Pollard and P. J. Morrison Proc R Soc Med. 1975 August; 68(8): 480�481.
The curly toes is a common congenital deformity characterised by flexion, varus deviation and lateral rotation at the distal interphalangeal joint. This paper reports a series of cases treated by flexor tenotomy.

Flexor to extensor tendon transfer for curly toes

Biyani et al — 2009-06-10 23:01:51 GMT

Biyani, Ashok, Jones, Dai Anthony and Murray, Judith M.(1992)'Flexor to extensor tendon transfer for curly toes',Acta Orthopaedica,63:4,451 � 454
43 children treated by flexor-to-extensor transfer for a total of 130 curly toes were retrospectively reviewed after a mean period of 8 years. According to an objective scoring system, 37 patients had a satisfactory result and 6 patients had a poor result of one or more toes. We now recommend that children with mild to moderate curly toes should be observed until the age of 6 years, by which time the majority will have had spontaneous correction. The remaining patients should be operated on at that stage because children operated on later had poor results. Attention should be paid to the surgical technique because the long flexor tendons are often bipartite.

Open flexor tenotomy for hammer toes and curly toes in childhood

Ross ER, Menelaus MB. — 2009-06-10 23:01:51 GMT

Sixty-two children were reviewed between 3 and 14 years (average 9.8 years) after flexor tenotomy for curly toes or hammer toes. No patients were aware of loss of flexor power in the toes. In only 5% of 188 toes was the operation unsuccessful. When the cause of failure was identifiable it proved to be that the scar crossed one or more flexor creases. None of the operated toes had an abnormally extended posture; only one toe was stiff and this resulted from tethering by a scar. It is concluded that open flexor tenotomy is an effective method for correcting curly toes and hammer toes in childhood. Pre-operative assessment must demonstrate that the resting length of the flexor tendons is unduly short, and that this shortening is the only cause of the deformity.
Ross ER, Menelaus MB. J Bone Joint Surg Br. 1984 Nov;66(5):770-1. (full text)