Overlapping and Underlapping Toes

Overlapping and underlapping toes are both congenital deformities that can lead to significant pain and irritation. They are usually treated by wearing appropriate footwear or orthotic devices. In severe cases, surgery may be necessary.
Sept. 24, 2009 - PRLog -- Overlapping Toes.  This deformity occurs when one of the toes lies on top of the adjacent toe.  It most commonly affects the fifth toe, but is also fairly common in the second toe (especially if the person has bunions).  The deformity can lead to complications such as blisters and calluses on top and between the toes as well as more permanent joint and bone damage.

Causes: Overlapping toes are most often classified as a congenital deformity.  Though they are not always recognizable at birth, if identified, corrective treatment can begin in infancy.  Some people develop overlapping toes as the result of other foot conditions.  Children with high arches or flat feet often distribute their weight improperly, which can cause the toes to permanently change their position.  Adults who wear shoes with narrow toe boxes or who suffer from bunions are also more likely to develop overlapping toes.

Treatment: The first step is to accommodate the deformity.  This includes purchasing shoes with wide and high toe boxes that will not put pressure on the toes.  A podiatrist may recommend orthotics such as toe combs or toe straighteners to help correct the position.  Occasionally surgery is necessary.  A simple surgery for overlapping toes may involve releasing the affected surgery.  A more complex procedure may involve inserting a pin into the bone of the foot.  

Underlapping Toes.  This congenital condition usually affects the fourth or fifth toes of the feet.  It is sometimes referred to as clinodactyly or curly toes because the affected toe tends to rotate slightly so that the top of the toe is facing the outside of the foot.  The toe (usually the fifth) then curls back towards the adjacent toe (usually the fourth).  This abnormal position of the toe usually leads to calluses developing on the affected toe.  Pain and irritation are common complaints.

Causes: Underlapping toes are generally considered to be a congenital condition.  There is a strong trend for the deformity in families.  Some podiatrists suggest that the deformity is the result of muscle imbalance in the muscles of the foot.  The deformity increases once the foot first bears weight.  

Treatment: Wearing shoes with high and wide toe boxes that do not put additional pressure on the foot can accommodate the deformity.  If the deformity is still flexible then a relatively simple tendon release surgery can be performed to correct the deformity.  If the deformity is rigid, then a more complicated surgery involving the removal of some parts of the bone may be necessary.

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