Pediatric Orthopedic Surgeons treating a Crooked Toe

CROOKED BIG TOE

Doctors and scientists estimate that over 20% of the US population suffers from toe deformities or “crooked” toes. There are many types of crooked toes including hammertoe, mallet toe, and claw toe. Additionally, toes can get pushed sideways, overlapping with the next toe, or they might rotate from their original position.

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Crooked Big Toe

Over half of all women in the United States have a crooked big toe, also known as a bunion and medically as hallux valgus. A bunion appears as a misalignment of the big toe that causes it to turn towards the other toes and form a bump on the inside of the foot. In some cases, the bunion causes pain, and if left untreated, bunions can lead to arthritis. Bunions tend to occur mostly among young teenagers, especially girls between the ages of 10-15. There are numerous bunion treatments. Our pediatric orthopedic surgeon will decide what treatment will benefit each patient based on the degree of hallux valgus deformity, existing other medical problems, and the patient’s personal situation, among other factors.

The big toe shifts out of place and points toward the outside edge of the foot. The often painful and inflamed, swollen metatarsal head in the metatarsophalangeal joint bulges and pushes against the shoe in the hallux valgus. In a hallux valgus deformity, the big toe first deviates toward the outside edge of the foot, almost always in conjunction with splayfoot. As a result of hallux valgus, the big toe tendon no longer runs parallel to the big toe. Instead, a deviation from the big toe’s normal alignment develops. This causes an inflamed protrusion in the joint, which grows and usually becomes painful. This is the protruding ball of the toe that is always associated with hallux valgus.

Causes

Congenital weakness of the connective tissue reveals a common cause of hallux valgus or bunions. Splayfoot always causes a big toe crookedness. The front arch of the foot (transverse arch) drops in splayfoot. The toes’ tips are flat on the ground. The toes point outward. Foot deformities caused by accidents or other foot injuries, such as fractures, can also encourage toe crookedness. Inflammatory changes in the joints can also cause the big toe to become crooked. Wearing too-tight shoes with high heels for years frequently encourages the growth of hallux valgus.

When a large portion of the body weight does not support the heel and longitudinal arch of the foot, the front transverse arch of the foot loses stability and Splayfoot develops. Other stress-related factors that contribute to the development of hallux valgus include that the tendons in the forefoot can become unstable when an overweight person stands for extended periods of time, causing a decline in the foot’s transverse arch.

Symptoms

Reddening and the formation of an enlarged ball at the metatarsophalangeal joint.
Less flexibility and stiffening of the big toe.
The big toe strays to one side.
The big toe turns by rotating it on its axis.
Reddening and calluses forming under the ball of the 2nd-4th toe’s metatarsus.

QUESTIONS AND ANSWERS

What causes a crooked big toe in children?

A crooked big toe in children can result from several factors, including genetics, abnormal foot mechanics, ill-fitting footwear, or underlying medical conditions. Bunions, a common cause, occur when the big toe gets forced inward towards the other toes, leading to a bony bump at the joint. Hallux valgus identifiess another condition where the big toe angles away from the midline of the foot, often due to muscle imbalances or improper footwear.

What common symptoms associate with a crooked big toe in children?

Symptoms of a crooked big toe may include visible deformity or misalignment of the big toe, a bony bump on the side of the foot near the big toe joint (bunion), pain or tenderness at the joint, difficulty wearing certain shoes, corns or calluses on the affected area, and limited range of motion of the big toe.

How do doctors treat a crooked toe in children?

Treatment for a crooked big toe in children depends on the cause and severity of the condition. Conservative measures may include wearing appropriate footwear with a wide toe box and good arch support, using padding or spacers to alleviate pressure on the big toe, performing toe-strengthening exercises, and using orthotic devices. In cases of bunions or severe deformity, surgical intervention may be necessary to realign the toe or remove the bony bump. The specific surgical approach will depend on the child’s age, overall health, and the extent of the deformity.

Schedule an appointment to have your child, teenager, or adolescent seen at Medical City Children’s Orthopedic and Spine Specialists for a crooked Big Toe diagnosis

Crooked Toe Diagnosis

Even laymen can recognize hallux valgus. When an orthopedist examines the foot, he or she will usually notice a hallux valgus deformity. Doctors find that Hallux valgus frequently has an enlarged angle in the joint. The physician’s diagnosis gets confirmed by the hallux valgus patient’s description of problems. An x-ray of the foot’s reliable performance to the diagnosis of hallux valgus. It shows the precise extent of the hallux valgus deformity.

The exact geometric deviation between the hallux valgus deformity and the normal position gets measured while standing – thus bearing weight – and doctors refer to it as the hallux valgus angle. Damage to cartilage, trapped soft tissue, and bone can all be detected using magnetic resonance imaging (MRI). Hallux valgus syndrome does pass down in families. As a result, the orthopedist asks about family members who also have hallux valgus.

Treatment

Women are primarily affected by hallux valgus (90% of sufferers are female). The prevalence of Hallux valgus rises noticeably with age. Some very young women and men in their teens get hallux valgus. The cause of Hallux valgus is then determined by genetics rather than overloading the feet. Hallux valgus becomes rare in countries where people go barefoot or wear open, comfortable shoes or sandals. Japan and China acknowledge excessive cases as this area of the world wears small, narrow shoes that they consider fashionable.

Non-Surgical Treatment for a Crooked Toe

Teenagers can avoid the development of hallux valgus by performing exercises that promote free movement of the big toe in all directions. However, very few people engage in such preventive measures beginning in adolescence. If the bunion occurs only once, conservative treatments may only relieve the symptoms. The following recommendations may alter the course and stop an adolescent bunion from enlarging and causing discomfort and pain.

Shoes

When orthopedists discover hallux valgus early, they can recommend better footwear.
To begin with, wear flat shoes with plenty of room for your child’s toes every day.
Treatment for mild hallux valgus includes hallux valgus insoles, which support the front arch and prevent splayfoot from progressing.
Hallux valgus shoes with more room for the bunion can reduce friction and thus swelling, inflammation, and hallux valgus pain.
Insoles can help with splayfoot: By raising the front arch, the forefoot narrows again. This reduces bunion irritation caused by friction inside the shoe and reduces swelling.
Consider using toe spacers and/or metatarsal pads: Toe spacers can speed up the recovery of damaged toes, but doctors recommend introducing them gradually, just like minimalist shoes. Metatarsal pads can help to restore natural foot function even more. Conventional shoes with tapered toe boxes and raised toe springs frequently cause the metatarsal arch (the arch beneath the ball of your child’s foot) to deform by pushing outwards. Metatarsal pads can be worn in shoes and placed just below the ball of your child’s foot, allowing the metatarsal arch to gradually return to its natural position.
Hallux valgus splints, which reduce pressure from the big toe to the adjacent toes help.
Avoid wearing tight socks or stockings.

Foot Care

Hallux valgus exercises and barefoot walking each day can help with development in the early stages of hallux valgus deformity. The front arch of the foot becomes naturally strengthened and sorted by activating and relaxing the foot and toe muscles. Muscles that have been well-trained and active since adolescence are required to provide shape and stability for a flexible arch. Only intact arches can stop the progression of the hallux valgus condition.
Our doctors recommend maintaining consistent skin care of the pressure spots when treating hallux valgus. Swelling and, as a result, friction inside the shoe directly contribute to hallux valgus pain. Skincare becomes essential for the conservative treatment of hallux valgus pain.
Develop Foot-Strengthening Habits: Following a change in footwear, there are a few healthy habits that will help reverse the damage caused by crooked or bent toes.
Massaging your child’s feet to help calluses and corns dissolve faster. Aside from hand massages, the pharmacies carry a variety of over-the-counter foot massage tools, such as spikey balls that you roll under your foot.
Practice foot strengthening exercises. Laying a towel on the floor and trying to pick it up with your child’s toes. This popular and inexpensive technique can occur while watching TV.
Take advice from a physical therapist on foot strengthening exercises and stretches to help your child regain strength and improve your child’s foundation.

Surgery

Only surgery for severe hallux valgus can provide long-term pain relief for those whose every step suffers. In adult patients, physical therapy exercises and a splint can only slow the progression of the disease. In this case, surgical bunion straightening remains the only treatment option for hallux valgus pain and preventing complications in the metatarsophalangeal joint. The orthopedic doctors at Medical City Children’s Orthopedics and Spine Specialists has offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX, and specializes in Children. As specialists, Doctors Richard Hostin, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD treat children for minor and major medical problems. In addition, we invite new patients to call and make an appointment. Also, we will see your child quickly and find a solution to get your child back to being the kid he or she is.

However, virtually all techniques for treating Hallux valgus follow the same guiding principle. Finally, the doctor will strengthen the big toe by correcting the tendons and joint capsule. This repositioning procedure on the big toe’s bone will usually straighten the toe.

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Footnote:

Healthline: What Causes a Crooked Big Toe

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