Deformities of the toes are common in the pediatric population. Generally they are congenital in nature with both or one of the parents having the same or similar condition. Many of these deformities are present at birth and can become worse with time. Rarely do children outgrow these deformities although rare instances of spontaneous resolution of some deformities have been reported.
Underlapping toes are commonly seen in the adult and pediatric population. The toes most often involved are the fourth and fifth toes. A special form of underlapping toes is called clinodactyly or congenital curly toes. Clinodactyly is fairly common and follows a familial pattern. One or more toes may be involved with toes three, four, and five of both feet being most commonly affected.
The exact cause of the deformity is unclear. A possible etiology is an imbalance in muscle strength of the small muscles of the foot. This is aggravated by a subtle abnormality in the orientation on the joints in the foot just below the ankle joint called the subtalar joint. This results in an abnormal pull of the ligaments in the toes causing them to curl. With weight bearing the deformity is increased and a folding or curling of the toes results in the formation of callous on the outside margin of the end of the toe. Tight fitting shoes can aggravate the condition.
Forefoot supports such as gel toe straighteners, gel toe caps and toe combs are often recommended to keep overlapping toes apart. These effective devices are designed to reduce friction to help relieve the discomfort.
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Elevating the leg will help the fluid to drain out of it. Putting your legs up as much as possible and as high as you can manage will all help in relieving the symptoms. Having the end of your bed elevated by around six inches so that your feet are a bit higher than your head will help reduce the swelling and help with drainage of the excess fluid.
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