Several operative procedures have been described for the
treatment of curly toes in children. It is a relatively
common deformity which may be related to intrinsic
muscle paresis, although this could not be clearly
demonstrated by Taylor (1951). Surgical treatment may
be by flexor-to-extensor tendon transfer, as originally
described by Girdlestone (Taylor 1951), to overcome the
presumed weakness of the intrinsic muscle pull, or by
simple flexor tenotomy, for which good results have been
reported by Ross and Menelaus (1984).

There have been retrospective studies comparing
the two procedures in children and in adults (Pyper 1958;
Parrish 1973 ; Pollard and Morrison 1975) but we are not aware of any double-blind, randomised, prospective
trials. We therefore present a four-year follow-up of 46
toes randomised to either flexor tenotomy or flexor-toextensor
tendon transfer.