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Biphalangeal Fifth Toe

Background: A biphalangeal fifth toe is a common variant in the European population. The frequency is higher in the Japanese population. It is considered an anatomical variant of the normal triphalangeal fifth toe. Methods: Patients divided into three study groups were retrospectively reviewed to determine the effect of a biphalangeal fifth toe on the occurrence of clinically symptomatic pathology of the fifth ray. Results: The prevalence of a biphalangeal fifth toe in patients with hammer or claw toes was 65%, bunionettes 47%, and overriding fifth toe 37%. Only for the group with hammer or claw toes was prevalence significantly higher than that in the control group (39%). Conclusion: The stiffness and rigidity of the biphalangeal fifth toe may predispose it for symptomatic hammer or claw toe.