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Curly Toe/ Crooked Toe

What Is a Curly Toe (Adductovarus Deformity of the 4th or 5th Toe) ?  

Adductovarus deformity can be genetic condition or develop overtime. This abnormal rotation and position can put pressure on the toe when wearing shoes or rubbing against the 4th or 5th toe.

Genetically some children will have joint that shifts the toe over and or under the 4th toe but most usually start out as mild deformities and get progressively worse over time.


The most common cause of of this condition is similar to hammertoes as a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) or neurological changes in the foot that occur over time in some people.

Hammertoes may be aggravated by shoes that do not fit properly.  Occasionally, hammertoe is the result of an earlier trauma to the toe from a shoe


Common symptoms include:

  • Pain or irritation of the affected toe when wearing shoes.

  • Corns and calluses (a buildup of skin) on the toe, between two toes or on the ball of the foot. Corns are caused by constant friction against the shoe. They may be soft or hard, depending on their location.

  • Bursitis


Although Adductovarus toes are readily apparent, to arrive at a diagnosis, Dr Martins will obtain a thorough history of your symptoms and examine your foot. During the physical examination, the doctor may attempt to reproduce your symptoms by manipulating your foot and will study the contractures of the toes. In addition, Dr Martins may take x-rays to determine the degree of the deformities and assess any changes that may have occurred.

Adductovarus toes are progressive—they do not go away by themselves and usually they will get worse over time. However, not all cases are alike—some hammertoes progress more rapidly than others. Once Dr. Martins has evaluated your hammertoes, a treatment plan can be developed that is suited to your needs.

Nonsurgical Treatment

There is a variety of treatment options for Adductovarus:

  • Padding corns and calluses. 

  • Changes in shoewear- Wider Shoes

  • Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance.

  • Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe. 

Surgical Options

Adductovarus is a structural problem and long term addressing the position of the toe is what is needed. There are many factors to assess when scheduling and preforming this surgery; some include, blood circulation, smoking, Hx of infections, patient compliance, etc.

But in general this an outpatient procedure preformed at the Surgery Center or Hospital under light sedation. No pins or hardware is needed, patients are able to walk after the surgery and recovery is a short 2 weeks period.


Always look for a Board Certified Foot & Ankle Surgeon with years of experience in this type surgery when choosing your doctor.

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