Pedal biphalangism with fracture

Case contributed by Dr Mahmoud Ibrahim Mekhaimar


Foot pain after trauma.

Patient Data

Age: 30 years
Gender: Female

Digital radiographic examination of the right foot revealed:

  • non-united oblique fracture of the shaft of proximal phalanx of the little toe. No significant displacement
  • the little toe shows two phalanges only
  • ankylosis of the middle and distal phalanges of 4th toe

Case Discussion

Symphalangism refers to ankylosis of the interphalangeal joints (i.e. the fusion of the phalanges) in either the toes or the fingers.

When it affects the toes, it is termed pedal biphalangism. Most frequently, it affects the 5th toe.

Most commonly seen as an isolated anatomical variant as a fusion of the middle and distal phalanges in the 5th toe.

In case of trauma to the little toe, this variant should be kept in mind as the fracture can be missed easily. 

Special thanks to Dr. Mostafa Khairy, MD. lecturer of Diagnostic & Interventional Radiology, Cairo University Hospitals.

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