👣 Section 715.10 · Toe Deformities

Nelson Textbook of Pediatrics 22nd Edition | Comprehensive coverage of toe deformities: Juvenile hallux valgus (bunion) — familial, ligamentous laxity, treat with shoe modification, surgery delayed until skeletal maturity. Curly toes — observation. Overlapping fifth toe — surgery if symptomatic. Polydactyly — most common congenital toe deformity. Syndactyly. Hammer, mallet, claw toes. Subungual exostosis, ingrown toenail, macrodactyly, annular bands.

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📋 30 Clinical Scenarios — Toe Deformities (Nelson 715.10)

📇 High‑Yield Review Cards

🩺 Clinical Recognition: Toe Deformities

Select a presentation to review diagnostic clues and management per Nelson 715.10.

📋 Stepwise Management of Toe Deformities

🔑 Key Principles — Nelson Section 715.10
• Hallux valgus: Female predominance, familial, associated with pes planus. Conservative: wide shoes, orthotics. Surgery only for pain, delayed until skeletal maturity.
• Curly toes: Flexor digitorum longus contracture. Usually asymptomatic, observation. Rare surgery if symptomatic.
• Overlapping fifth toe: Congenital. Surgery for symptomatic (pain with shoes).
• Polydactyly: Most common congenital toe deformity. Surgical excision at 9-12 months. Do NOT tie off — leaves painful stump.
• Syndactyly: Usually asymptomatic, no treatment. Surgery only if associated polydactyly.
• Hammer toe: Flexion at PIP. Surgery for pain.
• Subungual exostosis: Great toe, excision if symptomatic.
• Ingrown toenail: Proper nail trimming. Surgical partial nail removal if recurrent.

    ⚡ Reflex Prompts — Clinical Decisions

    📖 Summary: Toe Deformities (Nelson 715.10)