Toesare thedigitsof thefootof atetrapod.Animalspecies such ascatsthat walk on their toes are described as beingdigitigrade.Humans,and other animals that walk on the soles of their feet, are described as beingplantigrade;unguligradeanimals are those that walk onhoovesat the tips of their toes.
| Toes | |
|---|---|
 Toes on the human left foot. The innermost toe (left in image), which is normally called the big toe, is thehallux. | |
 Bones of the foot (thetoe bonesare the ones in green, blue and orange) | |
| Details | |
| Identifiers | |
| Latin | digiti pedis |
| MeSH | D014034 |
| TA98 | A01.1.00.046 |
| TA2 | 170 |
| FMA | 25046 |
| Anatomical terminology | |
Structure
There are normally five toes present on each human foot. Each toe consists of threephalanx bones,theproximal, middle, and distal,with the exception of the big toe (Latin:hallux). For a minority of people, the little toe also is missing a middle bone. The hallux only contains two phalanx bones, the proximal and distal. The joints between each phalanx are theinterphalangeal joints.The proximal phalanx bone of each toe articulates with themetatarsalbone of the foot at themetatarsophalangeal joint.Each toe is surrounded by skin, and present on all five toes is atoenail.
The toes are, frommedial to lateral:
- the first toe, also known as the hallux ( "big toe", "great toe", "thumb toe" ), the innermost toe;
- the second toe, ( "index toe", "pointer toe" );
- the third toe, ( "middle toe" );
- the fourth toe, ( "fore toe", "ring toe" );
- the fifth toe, ( "baby toe", "little toe", "pinky toe", "small toe" ), the outermost toe.
Muscles
Toe movement is generallyflexion and extension(movement toward the sole or the back of the foot, resp.) via musculartendonsthat attach to the toes on theanterior and superiorsurfaces of the phalanx bones.[1]: 573
With the exception of the hallux, toe movement is generally governed by action of theflexor digitorum brevisandextensor digitorum brevismuscles. These attach to the sides of the bones,[1]: 572–75 making it impossible to move individual toes independently.Muscles between the toeson their top and bottom also help to abduct and adduct the toes.[1]: 579 The hallux and little toe have unique muscles:
- The hallux is primarily flexed by theflexor hallucis longus muscle,located in the deepposteriorof the lower leg, via theflexor hallucis longustendon.Additional flexion control is provided by theflexor hallucis brevis.It is extended by theabductor hallucis muscleand theadductor hallucis muscle.
- The little toe has a separate set of control muscles and tendon attachments, theflexorandabductordigiti minimi. Numerous otherfoot musclescontribute to fine motor control of the foot. The connective tendons between the minor toes account for the inability to actuate individual toes.
Blood supply
The toes receive blood from the digital branches of theplantar metatarsal arteriesand drain blood into thedorsal venous archof the foot.[1]: 580–81
Nerve supply
Sensation to the skin of the toes is provided by five nerves. Thesuperficial fibular nervesupplies sensation to the top of the toes, except between the hallux and second toe, which is supplied by thedeep fibular nerve,and the outer surface of the fifth toe, supplied by thesural nerve.Sensation to the bottom of the toes is supplied by themedial plantar nerve,which supplies sensation to the great toe and inner three-and-a-half toes, and thelateral plantar nerve,which supplies sensation to the little toe and half of the sensation of the fourth toe.
Inhumans,the hallux is usually longer than the second toe, but in some individuals, it may not be the longest toe. There is aninheritedtrait in humans, where thedominantgenecauses a longer second toe ( "Morton's toe"or" Greek foot ") while thehomozygousrecessivegenotypepresents with the more common trait: a longer hallux.[2]People with the rare genetic diseasefibrodysplasia ossificans progressivacharacteristically have a short hallux which appears to turn inward, or medially, in relation to the foot.
Variation
Humans usually have five toes on each foot. When more than five toes are present, this is known aspolydactyly.Other variants may includesyndactylyorarachnodactyly.Forefoot shape, including toe shape, exhibits significant variation among people; these differences can be measured and have been statistically correlated withethnicity.[3]Such deviations may affect comfort and fit for various shoe types. Research conducted for the U.S. Army indicated that larger feet may still have smaller arches, toe length, and toe-breadth.[4]
Function
The human foot consists of multiple bones and soft tissues which support the weight of the upright human. Specifically, the toes assist the human whilewalking,[5]providing balance, weight-bearing, and thrust duringgait.
Clinical significance
A sprain or strain to the smallinterphalangeal jointsof the toe is commonly called astubbed toe.A sprain or strain where the toe joins to the foot is calledturf toe.
Long-term use of improperly sized shoes can cause misalignment of toes, as well as other orthopedic problems.
Morton's neuromacommonly results in pain and numbness between the third and fourth toes of the sufferer, due to it affecting the nerve between the third and fourth metatarsal bones.[6]
The big toe is also the most common locus ofingrown nails,and its proximal phalanx joint is the most common locus forgoutattacks.
Deformity
Deformities of the foot includehammer toe,trigger toe, and claw toe. Hammer toe can be described as an abnormal contraction or “buckling” of a toe. This is done by a partial or complete dislocation of one of the joints, which form the toes. Since the toes are deformed further, these may press against a shoe and cause pain. Deformities of the foot can also be caused byrheumatoid arthritisanddiabetes mellitus.Deformities may predispose toulcersand pain, especially when shoe-wearing.
A common problem involving the big toe is the formation ofbunions.These are structural deformities of the bones and thejointbetween the foot and big toe, and may be painful.[7]Similar deformity involving thefifth toeis described astailor's bunionor bunionette.
Inpolydactyly(which can also affect thefingers) one or more extra toes are present.
In reconstruction
A favourable option for the reconstruction of missing adjacentfingers[8]/multiple digit amputations, i.e. such as a metacarpal hand reconstruction, is to have a combined second and third toe transplantation.[9]Third and fourth toe transplantation to the hand in replacing lost fingers is also a viable option.[10]
History
Etymology
Tā
TheOld Englishterm fortoeistā(pluraltān). This is a contraction oftāhe,and derives from Proto-Germanic*taihwǭ(cognates: Old Norsetá,Old Frisiantāne,Middle Dutchtee,Dutchteen(perhaps originally a plural), Old High Germanzēha,GermanZehe), perhaps originally meaning 'fingers' as well (manyIndo-European languagesuse one word to mean both 'fingers' and 'toes', e.g.digit), and thus from PIE root*deyḱ-— 'to show'.[11]
Hallux
In classical Latin,hallex,[12][13]allex,[12][14]hallus[12]andallus,[12]with genitive(h)allicisand(h)alli,are used to refer to the big toe. The formhallux(genitive,hallucis) currently in use is however ablend wordof the aforementioned forms.[12][15]Comparepollex,the equivalent term for thethumb.
Evolution
Haeckeltraces the standardvertebratefive-toed schema fromfish finsviaamphibianancestors.[16]
Other animals
Inbirdswithanisodactylorheterodactylfeet, the hallux is opposed or directed backwards and allows for grasping and perching.
While the thumb is often mentioned[by whom?]as one of the signature characteristics in humans, this manual digit remains partially primitive and is actually present in allprimates.In humans, the mostderiveddigital feature is the hallux.[17]
See also
References
- ^abcdDrake, Richard L.; Vogl, Wayne; Tibbitts, Adam W.M. Mitchell; illustrations by Richard; Richardson, Paul (2005).Gray's anatomy for students.Philadelphia: Elsevier/Churchill Livingstone. p. 557.ISBN978-0-8089-2306-0.
- ^Online Mendelian Inheritance in Man(OMIM):Toes – relative lengths of first and second - 189200
- ^Hawes, MR; Sovak, D; Miyashita, M; Kang, SJ; Yoshihuku, Y; Tanaka, S (Jan 1994). "Ethnic differences in forefoot shape and the determination of shoe comfort".Ergonomics.37(1): 187–96.doi:10.1080/00140139408963637.PMID8112275.
- ^Freedman, A., Huntington, E.C., Davis, G.C., Magee, R.B., Milstead, V.M. and Kirkpatrick, C.M.. 1946. Foot Dimensions of Soldiers (Third Partial Report),Armored Medical Research Laboratory,Fort Knox,Kentucky.
- ^Janey Hughes, Peter Clark, & Leslie Klenerman.The Importance of the Toes in Walking.The Journal of Bone and Joint Surgery, Vol. 72-B, No. 2. March, 1990.[1]Archived2008-12-17 at theWayback Machine
- ^"Morton's Neuroma".RetrievedAugust 21,2012.
- ^American College of Foot and Ankle Surgeons."Bunions".Archived fromthe originalon 2011-12-08.Retrieved2008-03-05.
- ^Wei, Fu-Chan; Colony, Lee H.; Chen, Hung-Chi; Chuang, Chwei-Chin; Noordhoff, Samuel M. (1989). "Combined Second and Third Toe Transfer".Plastic and Reconstructive Surgery.84(4): 651–61.doi:10.1097/00006534-198984040-00016.PMID2780906.
- ^Cheng, Ming-Huei; Wei, Fu-Chan; Santamaria, Eric; Cheng, Shao-Lung; Lin, Chih-Hung; Chen, Samuel H. T. (1998). "Single versus Double Arterial Anastomoses in Combined Second- and Third-Toe Transplantation".Plastic & Reconstructive Surgery.102(7): 2408–12, discussion 2413.doi:10.1097/00006534-199812000-00021.PMID9858177.S2CID12036342.
- ^Lutz, Barbara S.; Wei, Fu-Chan (2002)."Basic Principles on Toe-to-Hand Transplantation"(PDF).Gung Medical Journal.25(9): 568–76.PMID12479617.Archived fromthe original(PDF)on 2014-01-04.Retrieved2014-01-04.
- ^"Online Etymology Dictionary".Toe.
- ^abcdeHyrtl, J. (1880).Onomatologia Anatomica. Geschichte und Kritik der anatomischen Sprache der Gegenwart.Wien: Wilhelm Braumüller. K.K. Hof- und Universitätsbuchhändler. p. 248–249.onlineat Biodiversity Library.
- ^Triepel, H. (1908). Memorial on the anatomical nomenclature of the anatomical society. In A. Rose (Ed.),Medical Greek. Collection of papers on medical onomatology and a grammatical guide to learn modern Greek(pp. 176–93). New York: Peri Hellados publication office.
- ^Lewis, C.T. & Short, C. (1879).A Latin dictionary founded on Andrews' edition of Freund's Latin dictionary.Oxford: Clarendon Press.
- ^Triepel, H. (1910).Die anatomischen Namen. Ihre Ableitung und Aussprache. Mit einem Anhang: Biographische Notizen.(Dritte Auflage). Wiesbaden: Verlag J.F. Bergmann.
- ^
Haeckel, Ernst Heinrich Philipp August(1874).The Evolution of Man.Library of Alexandria. Vol. 1. Library of Alexandria (published 1923).ISBN9781465548931.Retrieved31 August2019.
The thorough investigations of Gegenbaur have shown that the fish's fins [...] are many-toed feet. The various cartilaginous or bony radii that are found in large numbers in each fin correspond to the fingers of toes of the higher Vertebrates. The several joints of each fin-radius correspond to the various parts of the toe. Even in the Dipneusta the fin is of the same construction as in the fishes; it was afterwards gradually evolved into the five-toed form, which we first encounter in the Amphibia. The reduction of the number of toes to six, and then to five, probably took place in the second half of the Devonian period - at the latest, in the subsequent Carboniferous period - in those Dipneusta which we regard as the ancestors of the Amphibia. [...] The fact that the toes number five is of great importance, because they have clearly been transmitted from the Amphibia to all the higher Vertebrates. Man entirely resembles his amphibian ancestors in this respect, and indeed in the whole structure of the bony skeleton of his five-toed extremities. A careful comparison of the skeleton of the frog with our own is enough to show this. [...] There is absolutely no reason why there should be five toes in the fore and hind feet in the lowest Amphibia, the reptiles, and the higher Vertebrates, unless we ascribe it to inheritance from a common stem-form. Heredity alone can explain it. It is true that we find less than five toes in many of the Amphibia and of the higher Vertebrates. But in all these cases we can prove that some of the toes atrophied, and were in time lost altogether.
- ^Lovejoy, C. Owen; Suwa, Gen; Simpson, Scott W.; Matternes, Jay H.; White, Tim D. (October 2009)."The Great Divides: Ardipithecus ramidus Reveals the Postcrania of Our Last Common Ancestors with African Apes".Science.326(5949): 100–6.doi:10.1126/science.1175833.PMID19810199.S2CID19629241.