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Curly or Crossed Toes

Curly (sometimes referred to as crossed) toes are common and often resolve spontaneously. Reassurance can be given in the presence of the following;

  • No skin thickening, skin trauma or blistering.
  • Child not functionally limited (walking, play).
  • Child not in pain.

Consider referral if any of the below are identified:

  • Concern about joint disease (check joints elsewhere and not just the child's feet!)
  • Concern about skin thickening or blistering (check the child's shoes!)/ trauma / pressure from adjacent toes.
  • Limited mobility due to pain interfering with function (e.g., play, walking).
  • Underlapping toes are more likely than overlapping toes to cause a problem with shoe fitting.

Referral to paediatric orthopaedics is the usual pathway if there are concerns that curly toes may not be a normal variant or if there are underlapping toes. Any concern about joint disease warrants referral to paediatric rheumatology.

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