Comparative Radiographic Analysis of the Width of the Lesser Digit Proximal Phalangeal Heads

Kushkaran Kaur Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Asher Cherian Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Russell J Hill Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Andrew J. Meyr Department of Podiatric Surgery, Temple University School of Podiatric Medicine, Philadelphia, PA.

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Abstract

Background: Digital deformities represent a common presenting pathology and target for surgical intervention in podiatric medicine and surgery. The objective of this investigation was to compare the radiographic width of the heads of the lesser digit proximal phalanges.

Methods: One hundred and fifty consecutive feet with a diagnosis of digital deformity and performance of weight-bearing radiographs were analyzed. The maximum width of the heads of the lesser digit proximal phalanges were recorded from the radiographs utilizing computerized digital software.

Results: The mean±standard deviation (range) of the head of the second digit proximal phalanx was 9.74±0.87 mm (7.94-11.78), of the head of the third digit proximal phalanx was 9.00±0.91 mm (7.27-10.94), of the head of the fourth digit proximal phalanx was 8.49±1.01 mm (5.57-10.73), and of the head of the fifth digit proximal phalanx was 8.67±0.89 mm (6.50-11.75). The width of the head of the proximal phalanx decreased from the second digit to the third digit (p<0.001), decreased from the third digit to the fourth digit (p<0.001), and then increased from the fourth digit to the fifth digit (p=0.032).

Conclusions: The results of this investigation provide evidence in support of an anatomic and structural contribution to digital deformities. The width of the heads of the lesser digit proximal phalanges decreased from the second to the third to the fourth toes, and then subsequently increased with the fifth proximal phalangeal head.

Corresponding author: Andrew J. Meyr, DPM, Department of Podiatric Surgery, Temple University School of Podiatric Medicine, 148 N. 8th Street, Philadelphia, PA 19107. (E-mail: ajmeyr@gmail.com)
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