The Frequency of Biphalangeal Toes in the Turkish Population: A Radiographic Study

Abstract

Purpose: This study aimed to investigate the frequency of biphalangeal toes in the Turkish population. Materials and Methods: Radiographs of 1096 cases (n=1286 feet) between September 2020 and August 2022 were analyzed. Our study had 386 left foot radiographs, 439 right foot radiographs, and 189 bilateral radiographs. Foot radiographs were assessed for biphalangealism of the second to the fifth toe. Data regarding sex, age, side, the number of phalanges of the fifth, fourth, third, and second toe, and the reason for performing radiographs were assessed. Groups were compared using Fisher’s exact test and the Chi-square test. Results: The prevalence of biphalangealism in the fifth toe was found to be 35.70%, in the fourth toe 1.70%, in the third toe 0.50% and in the second toe 0.20%. The difference in the frequency of biphalangeal and triphalangeal toes regarding sex and the right/left foot was statistically insignificant (p=0.245, p=0.815 respectively). The asymmetrical distribution of the fifth biphalangeal toe was seen in 6.90%, and the asymmetrical distribution of the fourth biphalangeal toe was 0.50% in the 189 bilateral feet radiographs. Conclusions: With this study, we found and demonstrated that the incidence of biphalangeal fifth toe is 35.70% and that this anatomical variant in the Turkish population is similar to other Turkish studies. The biphalangeal fifth toe must be kept in mind during the assessment of a case with foot pathologies and foot radiographs. Additionally, biphalangealism is not observed in the 4th and 3rd fingers on the same foot without the 5th finger being biphalangeal.

Keywords

• foot anatomy
• two-phalanged toes toe symphalangism
• pedal biphalangism
• turkish population