Overriding or overlapping 5th (little) toes

Overlapping or overriding little toes is a common condition, frequently seen on both feet (bilateral condition). It is caused by soft-tissue contraction on top of the foot where the toe meets the foot. The tightness of the tissues can be dealt with sequentially, always involving release of the joint capsule (capsulotomy) and lengthening of the (extensor) tendon on top. In more pronounced deformities, the skin is also tight and may need to be lenghtened by a plastic technique, called a "plasty". In our practice this is either a V-Y-plasty or Z-plasty. Surgery to the toe bones is not normally undertaken.

Recurrence of the condition is possible but generally uncommon. The risk of some recurrence or residual deformity is cited as a 5–15% risk. Importantly, “recurrence” doesn't necessarily mean needing another operation.

Here are some examples from our practice: