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Incidence of long second toe among university students
The Foot (1997) 7.30-32 Q 1997 Pearson Professmu.
Ltd
Incidence of long second toe among university students H. B. Turgut, A. Anil, T. V. Peker, S. C. Ulukent Department of Anatom-v, Gazi University Faculty of Medicine, Ankara, Turkey SUMMARY In this study, the incidence of long second toe in university students aged 17-25 was examined. In male students the incidence of long second toe in 155 right feet was 9.03% and in 154 left feet 11.03%. In female students the incidence of long second toe in 150 right feet was 6.66% and the incidence in 150 left feet was 8.00%. The length difference of the second toes between males and females was significant: the second toe in males was longer than the second toe of female students.
INTRODUCTION
Relative toe lengths were studied in Sweden by Romanus during the period of 1948-1950 in 2307 schoolchildren between the ages of 7 and 17.’ This study was performed firstly to determine the incidence of long second toe among university students aged between 17 and 25. To determine the foot dimensions of Turkish people should help determine the standards for the manufacture of modern and healthy shoes.
MATERIALS
AND METHODS Fig. l-Measurement
Measurements were taken with the help of the millimetric table prepared according to Hall et al’s anthropometric measurement methods.* The foot that was being measured was put on the measurement table in a full weight-bearing position, while the other rested lightly on a raised 25-cm platform. The body was in a normal, upright position. The foot was placed on the measurement table so that the medial side would be touching the long side of the platform and the most prominent part of the heel would be touching the short side of it (Fig. 1). The lengths between the most projecting part of the heel, the tip of the first toe and the tip of the second toe were measured. In this study, they were named as T, and T, (Fig. 2A and B). The incidence of the long second toe study was carried out among 150 female and 155 male students (medical, dentistry and pharmaceutical) at Gazi University. One of the male students had a previous
table.
amputation of his left foot. A ‘Z’ test was used for comparing the ratios.
RESULTS
The incidence of having the long second right toe among 155 male right feet was 9.03% (14 cases). The incidence of having equal lengths of first and second toes was 5.80% (9 cases). The measurements made on 154 male left feet revealed the incidence of the long second left toe was 11.03% (17 cases) and the incidence of having equal first and second toes was 3.24% (5 cases). The incidence of the long second right toe among 150 female right feet was found to be 6.66% (10 cases) and the incidence of equal lengths of the first and second right toes was found to be 4.66% (7 cases). The results of measurements made on 150 female left feet were as follows: the incidence of having long second
Correspondence to H. B. Twgut, Department of Anatomy, Gazi University Faculty of Medicine, Besevler, Ankara 06500, Turkey.
30
Incidence of long second toe among university students
31
B
2-(A and B) The length between the most projecting part of the heel and the tip of the second toe (T,) and the first toe (‘I’,).
Fig.
A
toe was 8.00% (12 cases) and the incidence of having equal lengths of first and second toes was 2.00% (3 cases). When the ratios were compared with each other by using a ‘Z’ test, the following results were obtained: I. The difference between male and female average values of the right and left second toes’ lengths was found statistically significant (WO.01). 2. The difference between the ratios of males and females having equal first and second toes in right and left feet was not statistically significant (P>O.O5).
3. The difference between the ratios of maIes and females having longer first toes than the second
Table l--Data Sex
Comparison
Men Women Comparison
Men Women Comp~i~n
Men Women Comparison
Men Women
from incidence of long second toe study I1
Mean
SD
SEM
of the first right toes of men and women
155 150
26.47 24.03
1.26 1.00
0.100 0.082
of the second right toes of men and women
15.5 150
25.89 23.45
1.24 1.05
0.100 0.086
of the first left toes of men and women
154 150
26.48 24.074
1.26 0.950
0 100 0.078
of the second left toes of men and women
154 150
25.92 23.45
1.32 1.04
0.110 0.084
toes was not found statistically significant fP>0.05).
The results are summarized in Table 1. DISCUSSION
The shape of the human foot is uniquely humanoid, varying substantially from that of other primates in the alignment of the hallux, shortness of the phaIangeal bones and the relative massiveness of the tarsal bones. These adaptations have occurred to enhance the weight-bearing capacity and the ability to absorb the considerable forces associated with various modes of bipedal locomotion. Within the human species the variations of foot shape and proportion may appear to be relatively small but differences are noted in the pattern of toe lengths (digital patterning), height of the arch and instep (dorsum), relationship between foot length, ball and heel breadth, shape of the heel and the angularity and shape of the toes.3.4 Baba (1975) pointed out the importance of correlation between foot length and stature, but on the other hand no correlation could be recognized between foot length and body weight. At the same time, it was mentioned that the ideaf. shoe model could be formed by measuring foot length, foot breadth and ball girth carefully. When Baba made groups in foot length, for every 5-mm length he found the average foot length in all female groups was less than that of males.5
32
The Foot
Similarly, in this study the average value of foot lengths was found to be 26.50 cm in males and 24.037 cm in females. The average value for left feet was found to be 26.51 cm in males and 24.076 cm in females. Romanus investigated the relative lengths of the first and second toes in a series of 2307 children aged 7-17 years in elementary schools in Uppland, Sweden. The lengths of first and second toes were classified into 3-mm groups. As a result of the measurements, it was observed that the most extreme positive difference was between 19-21 mm and the greatest negative difference was between lo-12 mm. There tended to be more positive difference between the length of the first and second toes at higher age levels. When right and left feet were compared it was seen that 10% of children had feet of equal length while about 60% of them had the left foot longer than the right.’ Following the examination of right feet in males, the percentage of having the long second toe among 155 males was found to be 9.03% (14 cases) while the percentage of having equal lengths of the first and second toes was found to be 5.80% (9 cases). Measurements of the left foot in 154 males showed the percentage of the long second toe to be 11.03% (17 cases) while the percentage of having equal first and second toes was 3.24% (5 cases). On examination of the right foot in 150 females, the percentage of a long second toe was found to be 6.66% (10 cases) while the percentage having equal lengths of first and second toes was 4.66% (7 cases). Measurement of the left foot in 150 females showed the percentage of long second toe was 8.00% (12 cases). The percentage of having equal first and second toes was found to be 2.00% (3 cases). Following our investigations it was noticed that the findings of our measurements and Torsten Romanus’s measurements turned out to be identical.’ Hawes and his colleague? found evidence of different toe lengths in different societies. For instance,
the first toe length of North American people was 0.21 cm longer than Japanese people, whilst the second toe length of Japanese people was 0.13 cm longer than that of North Americans. Barry Johnson and his colleagues in their 1989 investigations discussed the pathogenesis, aetiology, diagnostic features and treatment of the crossover second toe deformity. According to them, a long second metatarsal may be one of the most important prominent predisposing factors for the crossover second toe deformity. On the other hand, Teitz and his colleagues stated that if the second toe in ballet dancers is longer than the first toe, this could cause degenerative joint diseases.6’7 In the light of these observations and findings it is believed that foot standardization, which could be achieved through the determination of characteristic foot size among university students aged 17-25, could be useful from the shoe manufacturing point of view. The practical implications of this study would seem to be that shoes should be designed to allow more space for the second toe. The fitness of a new pair of shoes should be tried on the left foot first which usually is bigger than the right. REFERENCES
1. Romanus T. Frequency of long second toe in Swedish children from Uppland province. Acta Genetica 1952; 3: 1599167. 2. Hall J G, Froster-Iskenius U G. Allanson J E. In: Handbook of physical measurements. Oxford-New York-Toronto. Oxford University Press, 1989. 3. Hawes M R, Sovak D, Miyashita M. Ethnic differences in forefoot shape and the determination of shoe comfort. Ergonomics 1994; 37: 187- 196. 4. Robinson J R, Frederick E C, Cooper L B. Running participation and foot dimensions. Medicine and science in sports and exercise 1984; 16: 200. 5. Baba K. Foot measurement for shoe construction with reference to the relationship between foot length, foot breadth and ball girth. J Human Ergo1 1975; 3: 149-156. 6. Johnson J B, Price T W. Crossover second toe deformity: Etiology and Treatment. J Foot Surg 1989; 28: 417420. 7. Treitz C C, Harrington R M, Wiley H. Pressures on the foot in pointe shoes. Foot and Ankle 1985; 5: 216221.
Ltd
Incidence of long second toe among university students H. B. Turgut, A. Anil, T. V. Peker, S. C. Ulukent Department of Anatom-v, Gazi University Faculty of Medicine, Ankara, Turkey SUMMARY In this study, the incidence of long second toe in university students aged 17-25 was examined. In male students the incidence of long second toe in 155 right feet was 9.03% and in 154 left feet 11.03%. In female students the incidence of long second toe in 150 right feet was 6.66% and the incidence in 150 left feet was 8.00%. The length difference of the second toes between males and females was significant: the second toe in males was longer than the second toe of female students.
INTRODUCTION
Relative toe lengths were studied in Sweden by Romanus during the period of 1948-1950 in 2307 schoolchildren between the ages of 7 and 17.’ This study was performed firstly to determine the incidence of long second toe among university students aged between 17 and 25. To determine the foot dimensions of Turkish people should help determine the standards for the manufacture of modern and healthy shoes.
MATERIALS
AND METHODS Fig. l-Measurement
Measurements were taken with the help of the millimetric table prepared according to Hall et al’s anthropometric measurement methods.* The foot that was being measured was put on the measurement table in a full weight-bearing position, while the other rested lightly on a raised 25-cm platform. The body was in a normal, upright position. The foot was placed on the measurement table so that the medial side would be touching the long side of the platform and the most prominent part of the heel would be touching the short side of it (Fig. 1). The lengths between the most projecting part of the heel, the tip of the first toe and the tip of the second toe were measured. In this study, they were named as T, and T, (Fig. 2A and B). The incidence of the long second toe study was carried out among 150 female and 155 male students (medical, dentistry and pharmaceutical) at Gazi University. One of the male students had a previous
table.
amputation of his left foot. A ‘Z’ test was used for comparing the ratios.
RESULTS
The incidence of having the long second right toe among 155 male right feet was 9.03% (14 cases). The incidence of having equal lengths of first and second toes was 5.80% (9 cases). The measurements made on 154 male left feet revealed the incidence of the long second left toe was 11.03% (17 cases) and the incidence of having equal first and second toes was 3.24% (5 cases). The incidence of the long second right toe among 150 female right feet was found to be 6.66% (10 cases) and the incidence of equal lengths of the first and second right toes was found to be 4.66% (7 cases). The results of measurements made on 150 female left feet were as follows: the incidence of having long second
Correspondence to H. B. Twgut, Department of Anatomy, Gazi University Faculty of Medicine, Besevler, Ankara 06500, Turkey.
30
Incidence of long second toe among university students
31
B
2-(A and B) The length between the most projecting part of the heel and the tip of the second toe (T,) and the first toe (‘I’,).
Fig.
A
toe was 8.00% (12 cases) and the incidence of having equal lengths of first and second toes was 2.00% (3 cases). When the ratios were compared with each other by using a ‘Z’ test, the following results were obtained: I. The difference between male and female average values of the right and left second toes’ lengths was found statistically significant (WO.01). 2. The difference between the ratios of males and females having equal first and second toes in right and left feet was not statistically significant (P>O.O5).
3. The difference between the ratios of maIes and females having longer first toes than the second
Table l--Data Sex
Comparison
Men Women Comparison
Men Women Comp~i~n
Men Women Comparison
Men Women
from incidence of long second toe study I1
Mean
SD
SEM
of the first right toes of men and women
155 150
26.47 24.03
1.26 1.00
0.100 0.082
of the second right toes of men and women
15.5 150
25.89 23.45
1.24 1.05
0.100 0.086
of the first left toes of men and women
154 150
26.48 24.074
1.26 0.950
0 100 0.078
of the second left toes of men and women
154 150
25.92 23.45
1.32 1.04
0.110 0.084
toes was not found statistically significant fP>0.05).
The results are summarized in Table 1. DISCUSSION
The shape of the human foot is uniquely humanoid, varying substantially from that of other primates in the alignment of the hallux, shortness of the phaIangeal bones and the relative massiveness of the tarsal bones. These adaptations have occurred to enhance the weight-bearing capacity and the ability to absorb the considerable forces associated with various modes of bipedal locomotion. Within the human species the variations of foot shape and proportion may appear to be relatively small but differences are noted in the pattern of toe lengths (digital patterning), height of the arch and instep (dorsum), relationship between foot length, ball and heel breadth, shape of the heel and the angularity and shape of the toes.3.4 Baba (1975) pointed out the importance of correlation between foot length and stature, but on the other hand no correlation could be recognized between foot length and body weight. At the same time, it was mentioned that the ideaf. shoe model could be formed by measuring foot length, foot breadth and ball girth carefully. When Baba made groups in foot length, for every 5-mm length he found the average foot length in all female groups was less than that of males.5
32
The Foot
Similarly, in this study the average value of foot lengths was found to be 26.50 cm in males and 24.037 cm in females. The average value for left feet was found to be 26.51 cm in males and 24.076 cm in females. Romanus investigated the relative lengths of the first and second toes in a series of 2307 children aged 7-17 years in elementary schools in Uppland, Sweden. The lengths of first and second toes were classified into 3-mm groups. As a result of the measurements, it was observed that the most extreme positive difference was between 19-21 mm and the greatest negative difference was between lo-12 mm. There tended to be more positive difference between the length of the first and second toes at higher age levels. When right and left feet were compared it was seen that 10% of children had feet of equal length while about 60% of them had the left foot longer than the right.’ Following the examination of right feet in males, the percentage of having the long second toe among 155 males was found to be 9.03% (14 cases) while the percentage of having equal lengths of the first and second toes was found to be 5.80% (9 cases). Measurements of the left foot in 154 males showed the percentage of the long second toe to be 11.03% (17 cases) while the percentage of having equal first and second toes was 3.24% (5 cases). On examination of the right foot in 150 females, the percentage of a long second toe was found to be 6.66% (10 cases) while the percentage having equal lengths of first and second toes was 4.66% (7 cases). Measurement of the left foot in 150 females showed the percentage of long second toe was 8.00% (12 cases). The percentage of having equal first and second toes was found to be 2.00% (3 cases). Following our investigations it was noticed that the findings of our measurements and Torsten Romanus’s measurements turned out to be identical.’ Hawes and his colleague? found evidence of different toe lengths in different societies. For instance,
the first toe length of North American people was 0.21 cm longer than Japanese people, whilst the second toe length of Japanese people was 0.13 cm longer than that of North Americans. Barry Johnson and his colleagues in their 1989 investigations discussed the pathogenesis, aetiology, diagnostic features and treatment of the crossover second toe deformity. According to them, a long second metatarsal may be one of the most important prominent predisposing factors for the crossover second toe deformity. On the other hand, Teitz and his colleagues stated that if the second toe in ballet dancers is longer than the first toe, this could cause degenerative joint diseases.6’7 In the light of these observations and findings it is believed that foot standardization, which could be achieved through the determination of characteristic foot size among university students aged 17-25, could be useful from the shoe manufacturing point of view. The practical implications of this study would seem to be that shoes should be designed to allow more space for the second toe. The fitness of a new pair of shoes should be tried on the left foot first which usually is bigger than the right. REFERENCES
1. Romanus T. Frequency of long second toe in Swedish children from Uppland province. Acta Genetica 1952; 3: 1599167. 2. Hall J G, Froster-Iskenius U G. Allanson J E. In: Handbook of physical measurements. Oxford-New York-Toronto. Oxford University Press, 1989. 3. Hawes M R, Sovak D, Miyashita M. Ethnic differences in forefoot shape and the determination of shoe comfort. Ergonomics 1994; 37: 187- 196. 4. Robinson J R, Frederick E C, Cooper L B. Running participation and foot dimensions. Medicine and science in sports and exercise 1984; 16: 200. 5. Baba K. Foot measurement for shoe construction with reference to the relationship between foot length, foot breadth and ball girth. J Human Ergo1 1975; 3: 149-156. 6. Johnson J B, Price T W. Crossover second toe deformity: Etiology and Treatment. J Foot Surg 1989; 28: 417420. 7. Treitz C C, Harrington R M, Wiley H. Pressures on the foot in pointe shoes. Foot and Ankle 1985; 5: 216221.