Minor toe abnormalities in children are very common and most are completely harmless. This is because childrens toes are usually very flexible and usually dont suffer from rubbing or pressure problems. As a principle treatment is not usually a good idea unless the toes are painful. Unnecessary toe surgery in childhood can cause problems with growth of the toes and lead to worse problems in the future. Some common toe problems are discussed below.
Overriding second toe.
The second toe quite often lies over the first or third toes in the young childs foot. As the foot becomes thinner with growth and spreads the weight the toe often comes to lie in line with the others. Treatment with strapping has no benefit and is unnecessary for something that will get better with time anyway.
Curly third and fourth toes.
Curling of these toes seldom cause problems even though they tend to sit under the next toe. Curly toes are never the reason for delayed walking in a child. If the toe causes no pain there is no need for treatment and strapping the toe or toe spacers do not correct the deformity. Occasionally the curly toe can cause pain from its nail digging in to the next toe. If this is the case lengthening a tendon in the toe usually allows the toes to become sufficiently straight to relieve the problem although this may take some weeks. Surgery cannot be justified for cosmetic reasons only due to the risk of making a painless toe into a painful one.
Over riding fifth toe
In this condition the fifth toe lies on top of the fourth toe. It looks quite ugly but causes surprisingly little in the way of symptoms. If there are symptoms such as pain or blistering then treatment is appropriate. Strapping or splints do not work so surgery is needed. There is a very small risk of loosing the toe with surgery. In most cases a satisfactory, though not perfect, result can be achieved.
Bunions are ten times more common in women than men and a bunion may begin to develop in adolescence. Correctly fitting shoes are important and fashion shoes with pointed toes are not recommended. Any shoes that have sufficient breadth and room in the front of the shoe for the toes are suitable. There is no treatment other than wearing shoes that fit which can prevent bunions from developing. Surgery may eventually become necessary for severe bunions and the operation is best left until adulthood since bunions tend to recur rapidly if the foot is still growing.