title: How many joints does the 5th toe have? A review of 606 patients of 655 foot radiographs.
abstract: BACKGROUND
  It is a common understanding that the fifth toe has three bones with two interphalangeal joints. However, our experience shows that a significant number have only two phalanges with one interphalangeal joint.
  
  
  METHODS
  We identified 676 patients listed as having had a foot radiograph, during an eight week period, of which 606 radiographs were available for the assessment. The radiographs were then assessed counting the number of phalanges in the fifth toe.
  
  
  RESULTS
  The patients consisted of 344 females and 262 males. Bilateral radiographs had been performed in 49 patients. 362 radiographs (55.3%) were found to have 3 phalanges in their 5th toe, with 291 (44.4%) having only two phalanges.
  
  
  CONCLUSIONS
  We have demonstrated the presence of two phalanges is a common anatomical variant. This finding has clinical implications with regard to the treatment of deformities of the fifth toe and the type of internal fixation device used.
authors.affiliation: Department of Orthopaedics, Royal United Hospital Bath NHS Trust, Coombe Park, Bath, United Kingdom. Lawrence.moulton@doctors.net.uk
authors.forename: Lawrence Stephen
authors.initials: LS
authors.lastname: Moulton
authors.forename: Seema
authors.initials: S
authors.lastname: Prasad
authors.forename: Robert G
authors.initials: RG
authors.lastname: Lamb
authors.forename: Siva P
authors.initials: SP
authors.lastname: Sirikonda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D014033:Toe Joint / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D055815:Young Adult