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.