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.