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The Prevalence of Biphalangealism for Each Toe in the Turkish Population: An Epidemiologic Study

Tunca CingozOrthopedics and Traumatology Department, Acıbadem University School of Medicine, Atasehir, Istanbul, Turkey.

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Yunus Emre OzdemirOrthopedics and Traumatology Department, Acıbadem University School of Medicine, Atasehir, Istanbul, Turkey.

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Mustafa SungurAcıbadem University Vocational School of Health Services, Istanbul, Turkey.

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Mehmet SahinAcıbadem University Vocational School of Health Services, Istanbul, Turkey.

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Dilara UstaAcıbadem University Vocational School of Health Services, Istanbul, Turkey.

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Birce Buturak KucukAcıbadem University Vocational School of Health Services, Istanbul, Turkey.

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Kerim SariyilmazOrthopedics and Traumatology Department, Acıbadem University School of Medicine, Atasehir, Istanbul, Turkey.

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Background: Biphalangealism has been evaluated in many studies and has been shown as a common variant. Its frequency varies according to the populations. This epidemiological study aimed to determine the prevalence of biphalangealism for each toe in the Turkish population and compare it with other populations.

Methods: The local hospital radiological database was searched for all consecutive foot radiographs, obtained between 2014 and 2018. Anteroposterior (AP) and oblique radiographs obtained to evaluate trauma or foot pathologies were included. Two-phalangeal toes according to radiographical views were defined as biphalangeal and other three-phalangeal toes were defined as normal.

Results: A total of 2,881 radiographs of 2,710 adult patients met the incusion criteria. There were 1,558 (57.5%) female and 1,152 (42.5%) male patients. The cases were unilateral in 2,539 patients and bilateral in 171 patients. The overall prevalence of biphalangeal third toe was 0.29%, fourth toe was 1.29%, and fifth toe was 23.3%.

Conclusions: The presence of pedal biphalangealism is a common variant and its frequency varies according to the populations. The exact cause is still unclear. Further studies are required to assess the clinical impact of biphalangealism.

Corresponding author: Yunus Emre Ozdemir, Resident Doctor, Orthopedics and Traumatology Department, Acıbadem University School of Medicine, Kayisdagi Cd. No:32, Atasehir, Istanbul 34752, Turkey. (E-mail: dryunusemreozdemir@gmail.com)