Bow legs / crooked toes in children

Curly toes (also known as crooked toes or twisted toes) involve a misalignment of the toe, often affecting the little toe. It is the most common congenital abnormality of the little toes. The condition is frequently seen in young children. When the child starts walking, the curled toes may become more noticeable. Curled toes in children usually run in the family, often affecting both feet.

A hammer toe is caused by an overly tight flexor tendon, which keeps the toe in a bent position. The toe is turned inwards and is bent, with the affected toe lying beneath the adjacent toe.

A curled toe often causes no symptoms, but it can cause pain in shoes due to pressure on the toe. This often results in discomfort and calluses on the top of the toe. It is particularly painful when walking, and the nail is sometimes damaged and sensitive.

Crooked toes do not usually cause any symptoms, which is why podiatrists do not treat them very often. Furthermore, the alignment of crooked toes improves spontaneously in 25 per cent of children.

If a child with club feet experiences persistent symptoms and pain, they can see a podiatrist for treatment. The treatment will consist of a (silicone) orthosis, taping and/or personalised advice on footwear. The expected outcome is reasonable to good, depending on the child’s age. The rotation of the toes cannot be corrected. If the symptoms persist after treatment, surgical correction may be considered.