Prevalence of pedal symphalangism in Turkish population. A radiographic survey

Selahattin Ozyurek, Ozkan Kose, Mustafa Celiktas, Bogachan Tokatman, Aziz Atik, Omer Faruk Kilicaslan


Objective: The purpose of this study is to investigate the prevalence of biphalengeal toes in Turkish population and to analyze the differences between genders and symmetry patterns. Material and methods: Bilateral foot radiographs of 279 subjects with a mean age of 40.7±16.3 (range, 18-78) years were reviewed to detect presence of pedal biphalangism. There were 146 (52.3%) female and 133 (47.7%) male subjects. Results: The overall prevalence of biphalangeal 3rd toe was 0.9%, 4th toe was 2.5% and 5th toe was 45.5%. The frequency of biphalangeal 3rd and 4th toe was statistically similar between genders (p=0.456 and p=0.163 respectively); however the biphalengeal 5th toe was more frequent in female subjects (p=0.004). In 138 (49.5%) subjects 5th toe was normal bilaterally. 113 (40.5%) subjects had bilateral 5th biphalangeal toe, and 28 (10.5%) subjects had biphalangeal 5th toe on one side (asymmetric pattern). 270 (96.8%) subjects had bilateral normal 4th toe, 5 (1.8%) subjects had bilateral biphalangeal 4th toe, and 4 subjects (1.4%) had asymmetric pattern. 276 (98.9%) subjects had bilateral normal 3rd toe, 2 (0.7%) had bilateral bipahangeal 3rd toe, and 1 subject (0.4%) had asymmetric pattern. The symmetric occurrence of biphalangeal toe in 3rd, 4th and 5th toes were equally distributed in both genders (p=0.061, p=0.227 and p=0.477 respectively). Conclusion: The present study represents the first report on the prevalence and distribution of biphalengeal toes in Turkish society. The prevalence of biphalengeal toes in Turkish population is considerably different from the Asian and Japanese population, but rather resembles European and North American populations.


biphalangeal; fifth toe; epidemiology; Turkish population; symphalangism

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