Help! I Have a Curly Fifth Toe!

A curly fifth toe, aka adductovarus of the fifth digit is a very common complaint of many patients. The fifth digit is notorious for rubbing against the inside of the shoe and the curling of the digit makes it even worse. Here is how we can make your curly digit feel better.

Conservative Methods

Taping of the fifth digit can help to de-rotate it, but this is not a permanent fix. With de-rotation of the digit there is also less pressure to the area since it will no longer be pressing on the inside of the shoe. Padding of the digit with a gel pad also helps to relieve symptoms of this prominent digit. Padding obviously decreased pressure and friction to the area therefore decreasing pain and irritation. Widening of the shoe is also a treatment to consider. A shoe cobbler in your local mall can use a shoe stretching device to make the toe box wider in order to alleviate irritation of the digit. This option is also cheaper than buying all new shoes. The conservative options do work really well depending on the activity level of the patient. The more abuse the digit endures the more pain will occur. Therefore surgical options may need to be considered.

Surgical Options

A de-rotational arthroplasty is the procedure of choice for a curly fifth toe. What this procedure entails is a small opening on the top of the fifth digit and then removing a small portion of the toe bone. Once this is completed the soft tissue is used to de-rotate the toe into a more rectus position. The digit after the stitches are completed is now sitting in a corrected position. This procedure is very effective and is only considered after failure of conservative therapy.


The most common complications of fifth digit surgery is swelling. Whenever surgery is performed on a little toe the swelling can be significant. That is why it is very important to elevate and ice the foot after surgery. Ibuprofen can be used to decrease the swelling as well. Infection, overcorrection, under correction, and chronic pain although rare can happen as well. The doctor will communicate with you during your post op visits of the status of the surgery and will also take X-rays to show the boney healing.

If you or a loved one have a curly toe please feel free to make an appointment so that we can help alleviate your pain. Call 813-875- 0555 today so that we can keep you on your feet and running.