Curly toe is a common congenital deformity characterized by flexion and varus deformity of the interphalangeal joints. Third and fourth toes are frequently affected and most patients don't have symptoms. Sweetnam stated that treatment was unnecessary because of the lack of symptoms and self-corrective nature. He indicated that 25% of his patients showed
spontaneous improvement, even if untreated. He stated observation had the same success rate as treatment with toe strapping and was less painful. Answers 1, 2, and 4 are all surgical techniques discussed but are not the gold standard for initial treatment. Surgery is considered if symptoms are present (pain, difficulty with shoe wear, nail problems) after age 3 years.
Sweetnam R. Congenital curly toes; an investigation into the value of treatment. Lancet. 1958 Aug 23;2(7043):398-400
PMID:13576819 (Link to Abstract)