Editing Toe

{{pp-vandalism|small=yes}}
{{short description|Digit of a foot}}
{{About|the body part||Toe (disambiguation)|and|Toes (disambiguation)}}
{{Redirect|Baby toe|plant|Fenestraria}}
{{Infobox anatomy
| Name        = Toes
| Latin       = digiti pedis
| Image       = toes.png
| Caption     = Toes on the human left foot. The innermost toe (left in image), which is normally called the big toe, is the ''[[Toe#Hallux|hallux]]''.
| Image2      = Ospied-en.svg
| Caption2    = Bones of the foot (the [[Phalanges of the foot|toe bones]] are the ones in green, blue and orange)
| Precursor   = 
| System      = 
| Artery      = 
| Vein        = 
| Nerve       = 
| Lymph       = 
}}
'''Toes''' are the [[Digit (anatomy)|digit]]s of the [[foot]] of a [[tetrapod]]. [[Animal]] species such as [[cat]]s that walk on their toes are described as being ''[[digitigrade]]''. [[Human]]s, and other animals that walk on the soles of their feet, are described as being ''[[plantigrade]]''; ''[[unguligrade]]'' animals are those that walk on [[hoof|hooves]] at the tips of their toes.

==Structure==
[[File:Gray269.png|thumb|Bones of the right [[foot]]. [[Plantar]] surface.]]
[[File:Foot on white background (cropped).jpg|thumb|Human toes]]
[[File:Metti (cropped).JPG|thumb|A woman's toes decorated with [[nail polish]] and [[henna]], and wearing a ''metti'' ([[toe ring]]) on the second toe, for her wedding]]

There are normally five toes present on each human foot. Each toe consists of three [[phalanx bone]]s, the [[Anatomical terms of location#Proximal and distal|proximal, middle, and distal]], with the exception of the big toe ({{langx|la|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 the [[Interphalangeal joints of foot|interphalangeal joints]]. The proximal phalanx bone of each toe articulates with the [[metatarsal]] bone of the foot at the [[Metatarsophalangeal joints|metatarsophalangeal joint]]. Each toe is surrounded by skin, and present on all five toes is a [[toenail]].

The toes are, from [[Medial (anatomy)|medial 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===
{{See also|Foot#Muscles}}
Toe movement is generally [[Anatomical terms of movement#Flexion and extension|flexion and extension]] (movement toward the sole or the back of the foot, resp.) via muscular [[tendon]]s that attach to the toes on the [[Anatomical terms of location#Anterior and superior|anterior and superior]] surfaces of the phalanx bones.<ref name="GRAYS2005">{{cite book|title=Gray's anatomy for students|last=Drake|first=Richard L.|author2=Vogl, Wayne|author3=Tibbitts, Adam W.M. Mitchell|author4=illustrations by Richard|author5=Richardson, Paul|publisher=Elsevier/Churchill Livingstone|year=2005|isbn=978-0-8089-2306-0|location=Philadelphia|pages=557}}</ref>{{rp|573}}

With the exception of the hallux, toe movement is generally governed by action of the [[flexor digitorum brevis]] and [[extensor digitorum brevis]] muscles. These attach to the sides of the bones,<ref name=GRAYS2005 />{{rp|572–75}} making it impossible to move individual toes independently. [[Dorsal interossei of the foot|Muscles between the toes]] on their top and bottom also help to abduct and adduct the toes.<ref name=GRAYS2005 />{{rp|579}} The hallux and little toe have unique muscles:
* The hallux is primarily flexed by the [[flexor hallucis longus muscle]], located in the deep [[posterior (anatomy)|posterior]] of the lower leg, via the [[flexor hallucis longus]] [[tendon]]. Additional flexion control is provided by the [[flexor hallucis brevis]]. It is extended by the [[abductor hallucis muscle]] and the [[adductor hallucis muscle]]. 
* The little toe has a separate set of control muscles and tendon attachments, the [[flexor digiti minimi brevis muscle (foot)|flexor]] and [[abductor digiti minimi muscle (foot)|abductor]] digiti minimi. Numerous other [[:Category:Foot muscles|foot muscles]] contribute 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 the [[plantar metatarsal artery|plantar metatarsal arteries]] and drain blood into the [[dorsal venous arch]] of the foot.<ref name=GRAYS2005 />{{rp|580–81}}

===Nerve supply===
Sensation to the skin of the toes is provided by five nerves. The [[superficial fibular nerve]] supplies sensation to the top of the toes, except between the hallux and second toe, which is supplied by the [[deep fibular nerve]], and the outer surface of the fifth toe, supplied by the [[sural nerve]]. Sensation to the bottom of the toes is supplied by the [[medial plantar nerve]], which supplies sensation to the great toe and inner three-and-a-half toes, and the [[lateral plantar nerve]], which supplies sensation to the little toe and half of the sensation of the fourth toe.

In [[human]]s, the hallux is usually longer than the second toe, but in some individuals, it may not be the longest toe. There is an [[Mendelian inheritance|inherited]] trait in humans, where the [[Dominance (genetics)|dominant]] [[gene]] causes a longer second toe ("[[Morton's toe]]" or "Greek foot") while the [[Zygosity|homozygous]] recessive [[genotype]] presents with the more common trait: a longer hallux.<ref>{{OMIM|189200|Toes&nbsp;– relative lengths of first and second}}</ref> People with the rare genetic disease [[fibrodysplasia ossificans progressiva]] characteristically 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 as [[polydactyly]]. Other variants may include [[syndactyly]] or [[arachnodactyly]]. Forefoot shape, including toe shape, exhibits significant variation among people; these differences can be measured and have been statistically correlated with [[ethnicity]].<ref>{{cite journal|last=Hawes|first=MR|author2=Sovak, D |author3=Miyashita, M |author4=Kang, SJ |author5=Yoshihuku, Y |author6= Tanaka, S |title=Ethnic differences in forefoot shape and the determination of shoe comfort.|journal=Ergonomics|date=Jan 1994|volume=37|issue=1|pages=187–96|pmid=8112275|doi=10.1080/00140139408963637}}</ref>  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.<ref name='freedman_army'>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.</ref>

==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 while [[walking]],<ref name="toe_walking">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. [http://www.jbjs.org.uk/cgi/reprint/72-B/2/245.pdf] {{Webarchive|url=https://web.archive.org/web/20081217152446/http://www.jbjs.org.uk/cgi/reprint/72-B/2/245.pdf |date=2008-12-17 }}</ref> providing balance, weight-bearing, and thrust during [[gait]].

==Clinical significance==
{{anchor|stubbed toe}}A sprain or strain to the small [[Interphalangeal articulations of foot|interphalangeal joints]] of the toe is commonly called a '''stubbed toe'''. A sprain or strain where the toe joins to the foot is called [[turf toe]].

Long-term use of improperly sized shoes can cause misalignment of toes, as well as other orthopedic problems.

[[Morton's neuroma]] commonly 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.<ref>{{cite web | url=http://www.patient.info/health/Morton%27s-Neuroma.htm | title=Morton's Neuroma | access-date=August 21, 2012}}</ref>

The big toe is also the most common locus of [[ingrown nail]]s, and its proximal phalanx joint is the most common locus for [[gout]] attacks.

===Deformity===
{{Main|Hammer toe|Bunion}}
Deformities of the foot include [[hammer 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 by [[rheumatoid arthritis]] and [[diabetes mellitus]]. Deformities may predispose to [[ulcer]]s and pain, especially when shoe-wearing.

A common problem involving the big toe is the formation of [[bunion]]s. These are structural deformities of the bones and the [[joint]] between the foot and big toe, and may be painful.<ref>{{cite web |url=http://www.footphysicians.com/footankleinfo/bunions.htm |author=American College of Foot and Ankle Surgeons |title=Bunions |access-date=2008-03-05 |archive-date=2011-12-08 |archive-url=https://web.archive.org/web/20111208042651/http://www.footphysicians.com/footankleinfo/bunions.htm |url-status=dead }}</ref> Similar deformity involving the [[fifth toe]] is described as [[tailor's bunion]] or bunionette.

[[File:X-ray of feet in polydactyly.jpg|thumb|Right-sided duplication of the right little toe in an 8.5 months old male, with two toes (fifth and sixth) apparently forming joints with the fifth metatarsal bone, which is mildly broadened distally. The duplicated toes have almost normal growth. The fifth toe has mild [[Varus deformity|varus angulation]], and the sixth toe has substantial [[Valgus deformity|valgus angulation]].]]

In [[polydactyly]] (which can also affect the [[finger]]s) one or more extra toes are present.

===In reconstruction===
A favourable option for the reconstruction of missing adjacent [[finger]]s<ref>{{cite journal |pmid=2780906 |year=1989 |last1=Wei |first1=Fu-Chan |last2=Colony |first2=Lee H. |last3=Chen |first3=Hung-Chi |last4=Chuang |first4=Chwei-Chin |last5=Noordhoff |first5=Samuel M. |title=Combined Second and Third Toe Transfer |volume=84 |issue=4 |pages=651–61 |journal=Plastic and Reconstructive Surgery |doi=10.1097/00006534-198984040-00016}}</ref>/multiple digit amputations, i.e. such as a metacarpal hand reconstruction, is to have a combined second and third toe transplantation.<ref>{{cite journal |doi=10.1097/00006534-199812000-00021 |pmid=9858177 |title=Single versus Double Arterial Anastomoses in Combined Second- and Third-Toe Transplantation |year=1998 |last1=Cheng |first1=Ming-Huei |last2=Wei |first2=Fu-Chan |last3=Santamaria |first3=Eric |last4=Cheng |first4=Shao-Lung |last5=Lin |first5=Chih-Hung |last6=Chen |first6=Samuel H. T. |journal=Plastic & Reconstructive Surgery |volume=102 |issue=7 |pages=2408–12; discussion 2413 |s2cid=12036342 }}</ref> Third and fourth toe transplantation to the hand in replacing lost fingers is also a viable option.<ref>{{cite journal |first1=Barbara S. |last1=Lutz |first2=Fu-Chan |last2=Wei |title=Basic Principles on Toe-to-Hand Transplantation |journal=Gung Medical Journal |url=http://memo.cgu.edu.tw/cgmj/2509/250901.pdf |pmid=12479617 |year=2002 |volume=25 |issue=9 |pages=568–76 |access-date=2014-01-04 |archive-date=2014-01-04 |archive-url=https://web.archive.org/web/20140104042745/http://memo.cgu.edu.tw/cgmj/2509/250901.pdf |url-status=dead }}</ref>

==History==

===Etymology===

==== {{Transliteration|ang|Tā}} ====
The [[Old English]] term for ''toe'' is {{Transliteration|ang|tā}} (plural {{Transliteration|ang|tān}}). This is a contraction of {{Transliteration|ang|tāhe}}, and derives from Proto-Germanic {{Lang|gem-x-proto|*taihwǭ}} (cognates: Old Norse {{Transliteration|non|tá}}, Old Frisian {{Transliteration|ofs|tāne}}, Middle Dutch {{Lang|dum|tee}}, Dutch {{Lang|nl|teen}} (perhaps originally a plural), Old High German {{Lang|goh|zēha}}, German {{Lang|de|Zehe}}), perhaps originally meaning 'fingers' as well (many [[Indo-European language]]s use one word to mean both 'fingers' and 'toes', e.g. ''digit''), and thus from PIE root {{Lang|ine-x-proto|*deyḱ-}} &mdash; 'to show'.<ref>{{cite web |url=http://etymonline.com |title=Online Etymology Dictionary |at=[http://etymonline.com/index.php?allowed_in_frame=0&search=toe&searchmode=none Toe]}}</ref>

===={{Lang|la|Hallux}}====
[[File:PaluchUStopy.jpg|thumb|The big toe of a human]]

In classical Latin, {{Lang|la|hallex}},<ref name="Hyrtl1880">Hyrtl, J. (1880). ''Onomatologia Anatomica. Geschichte und Kritik der anatomischen Sprache der Gegenwart.'' Wien: Wilhelm Braumüller. K.K. Hof- und Universitätsbuchhändler. p. 248–249. [https://www.biodiversitylibrary.org/item/69009#page/270/mode/1up online] at Biodiversity Library.</ref><ref name="Triepel1908">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.</ref> {{Lang|la|allex}},<ref name="Hyrtl1880" /><ref name="Lewis & Short">Lewis, C.T. & Short, C. (1879). ''A Latin dictionary founded on Andrews' edition of Freund's Latin dictionary.'' Oxford: Clarendon Press.</ref> {{Lang|la|hallus}}<ref name="Hyrtl1880" /> and {{Lang|la|allus}},<ref name="Hyrtl1880" /> with genitive {{Lang|la|(h)allicis}} and {{Lang|la|(h)alli}}, are used to refer to the big toe. The form {{Lang|la|hallux}} (genitive, {{Lang|la|hallucis}}) currently in use is however a [[blend word]] of the aforementioned forms.<ref name="Hyrtl1880"/><ref name="Triepel1910b">Triepel, H. (1910). ''Die anatomischen Namen. Ihre Ableitung und Aussprache. Mit einem Anhang: Biographische Notizen.''(Dritte Auflage). Wiesbaden: Verlag J.F. Bergmann.</ref> Compare [[wikt:pollex|''pollex'']], the equivalent term for the [[thumb]].

=== Evolution ===
[[Ernst Haeckel |Haeckel]] traces the standard [[vertebrate]] five-toed schema from [[fish fin]]s via [[amphibian]] ancestors.<ref>
{{cite book
 | last1 = Haeckel
 | first1 = Ernst Heinrich Philipp August
 | author-link1 = Ernst Haeckel
 | year = 1874
 | title = The Evolution of Man
 | url = https://books.google.com/books?id=Vu8X-Pe-dMoC
 | series = Library of Alexandria
 | volume = 1
 | publisher = Library of Alexandria
 | publication-date = 1923
 | isbn = 9781465548931
 | access-date = 31 August 2019
 | quote = 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.
}}
</ref>

==Other animals==
[[File:Pakicetidae_-_Pakicetus_attocki.JPG|thumb|The skeleton of ''[[Pakicetus]]'', an extinct digitigrade mammal.]]
In [[bird]]s with [[anisodactyl]] or [[heterodactyl]] feet, the hallux is opposed or directed backwards and allows for grasping and perching.

While the thumb is often mentioned{{by whom?|date=August 2019}} as one of the signature characteristics in humans, this manual digit remains partially primitive and is actually present in all [[primates]]. In humans, the most [[Synapomorphy |derived]] digital feature is the hallux.<ref>{{cite journal
| last1 = Lovejoy | first1 = C. Owen
| last2 = Suwa | first2 = Gen
| last3 = Simpson | first3 = Scott W.
| last4 = Matternes | first4 = Jay H.
| last5 = White | first5 = Tim D.
| title = The Great Divides: Ardipithecus ramidus Reveals the Postcrania of Our Last Common Ancestors with African Apes
| journal = Science |date=October 2009 | volume = 326 | issue = 5949 | pages = 100–6
| doi = 10.1126/science.1175833
| url = https://www.science.org/doi/abs/10.1126/science.1175833
| pmid = 19810199
| s2cid = 19629241 | url-access = subscription}}
</ref>

==See also==
{{Anatomy-terms}}
{{Commons category|Toes}}
* [[Ainhum]]
* [[Finger]]
* [[Morton's toe]]
* [[Nail (anatomy)]]
* [[Polydactyly]] and [[syndactyly]]
* [[Subungual hematoma|Runner's toe]]
* [[Toe cleavage]]
* [[Toe tag]]
* [[Toecuffs]]
* [[Webbed toes]]

==References==
{{Reflist|2}}

{{Human regional anatomy}}
{{Authority control}}

[[Category:Foot]]
[[Category:Podiatry]]
[[Category:Toes|*]]