Initial pre-referral workup

Clinical history

• one or more of the lessor toes curves medially
• usually affects one or more of the outer three digits
• may push 2nd toe up and cause it to bend laterally
• may be familial

Physical examination

• usually passively correctable
• may look worse when standing
• look for redness or callosities

Investigations

• nil
• X-rays are of no use

GP management

• benign toe condition
• usually cosmetic
• reassurance
• many cases resolve with growth

Indications for specialist referral

This condition is not accepted for referral UNLESS:

Routine referral

• over the age of five years
• significant deformity causing rubbing and callosity