Underlapping toes usually involve the fourth and fifth toes. (A special form of underlapping toes is called congenital curly toes.) The cause of underlapping toes is unknown. Many experts suspect they are caused by an imbalance in the small muscles of the foot.
At a younger age, or when the toes are fairly flexible, a simple release of the tendon in the bottom of the toe usually helps. If the deformity is rigid, surgery may be required to remove a small portion of the bone in the toe.
Overlapping toes are characterized by one toe lying on top of an adjacent toe. The fifth toe is the most affected digit with overlapping toes. Overlapping toes are believed to originate during pre-natal development.
Passive stretching and adhesive taping is most commonly used to correct overlapping toes in infants, but the deformity usually recurs.
Surgical correction sometimes involves releasing the tendon and the soft tissues around the joint at the base of the fifth toe. In severe cases, a pin may need to be surgically inserted to hold the toe in a straight position. The pin, which exits the tip of the toe, may be left in place for up to three weeks