Overlapping Toe Deformity

An overlapping toe is more serious than it seems – it is actually a form of hammertoe , and if not treated can cause friction, discomfort, and severe irritation.

Patients with overlapping toes, especially those with overlapping 5th toe, are usually advised to wear shoes with roomy toe boxes, use supports such as gel toe straighteners, toe comps and toe caps that help keep toes separated.

Signs and Symptoms

Common symptoms of overlapping toes include pain and inflammation. Some patients also develop calluses . An overlapping toe can affect walking as the toes may rub with the shoes and cause irritation and pain. Many types shoes (ladies’ shoes, especially) are not designed to comfortably accommodate an overlapping toe.

If the condition is not treated immediately and correctly, it can get in the way of normal foot activities and function.

Causes and Risk Factors

Overlapping toes are usually caused by hammertoes, which may be genetic or developed. Muscle imbalances from walking the wring way is the main cause of hammertoes. In some cases, though, it caused by inherited foot structure, such as long second toes (Morton's Toe) , stiff tendons that keep toes from resting flat, etc. Bunions on the big toe can also force the second toe to cramp. Narrow shoes are also culprits, as they force the toes to crowd together.

Tests & Diagnosis

A doctor typically only needs a physical exam to diagnose an overlapping toe.

Overlapping Toes Treatment

Conservative Treatments

In most cases, conservative treatment can already solve the problem of overlapping toes. Patients are usually advised to wear footwear with broad toe boxes. Most patients are also advised to wear supports –gel toe straighteners, toe combs, and gel toe caps are among the many products that help keep overlapping toes away from each other. Used correctly, these simple devices significantly reduce friction and alleviate pain and discomfort in the long run.

Surgery may be required in severe cases. Surgery can solve problems such as an overlapping 5th toe caused by dorsal-adduction deformity, contracture of the EDL tendon, or external rotation of the digit.

Surgical Methods

There are generally two types of overlapping toe surgery:

DuVries Correction

Butler's Surgical Correction

Butler's Surgical Correction, on the other hand, involves creating a dorsal racket incision above the little digit, allowing detoration of the toe. The doctor typically does a second ‘handle’ incision on the plantar aspect of the initial wound so that the toe can be moved plantarly and laterally. The contracted extensor and the dorsal capsule are then released. Some cases require that the plantar capsule be releases by means of the dorsal capsule.

No two overlapping toe conditions are exactly the same, so surgical procedures may differ from case to case. It is best to consult more than one doctor before deciding to undergo surgery. A good doctor should be able to explain to you your foot’s unique condition and how it can be best solved.

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