Summary
Curly toe is a common congenital deformity characterized by flexion and varus deformity
of the interphalangeal joints. Because this minor deformity is seldom accompanied
with any symptoms, treatment strategy has rarely been discussed in detail in the literature.
Eight toes in seven patients with curly toe were treated by open tenotomy of the medial
slip of the flexor digitorum brevis tendon. If sufficient correction was not obtained,
the collateral ligament and the volar plate of the proximal interphalangeal joint
were dissected. The skin defect at the plantar base of the toe was covered using a
local flap or a full-thickness skin graft. The median age at operation was 2 years
6 months (ranged from 8 months to 5 years 4 months). In all cases, contracture of
the plantar skin at the base of the toe and tight FDB tendon were recognized to a
variable degree. Postoperatively, overlapping of the affected toe was corrected in
every case at a median follow-up of 2 years 9 months. However, flexion and/or varus
deformity tended to remain to some degree in those patients with severe curly toe.
Toes with moderate to severe deformity with overlapping beneath the adjacent toe are
candidates for surgical correction, because spontaneous correction is unlikely and
troublesome symptoms may occur as the child grows older. Surgical correction should
be performed until 2–3 years of age. The postoperative result might be poor, if treated
in the older age, because skeletal deformity is likely to occur. Open tenotomy of
the FDB tendon is easy to perform, and toe function was seldom impaired.
Keywords
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Article info
Publication history
Published online: March 12, 2007
Accepted:
August 16,
2006
Received:
April 7,
2006
Footnotes
☆Previously presented at the 47th meeting of the Japan Society of Plastic and Reconstructive Surgery; April 7–9, 2004; Tokyo, Japan.
Identification
Copyright
© 2007 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
