Interphalangeal sesamoid bones of the great toe: An anatomic variant demanding careful scrutiny of radiographs

Davies, Mark B.; Abdlslam, Kalid M.; Gibson, Richard J.

doi:10.1002/ca.10147

Cited by 13 publications

(9 citation statements)

References 6 publications

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“…In a cadaveric study of Japanese subjects, the prevalence was 96% in dissected specimens compared to 91% seen on radiographs (Masaki, 1984), probably reflecting the relative radiolucency of small bones or their composition of cartilage. In addition to this, Davies et al (2003) suggested a possible racial link between differences in IPJ ossicle prevalence because most of the literature regarding trauma to these ossicles is Japanese (Masaki, 1984;Miki et al, 1988;Yasuda et al, 1990). We report the prevalence of IPJ nodules in 40 British Caucasian cadavers, a group for whom the prevalence has not been determined.…”

Section: Discussionmentioning

confidence: 83%

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Gross anatomy of the interphalangeal joint of the great toe: Implications for excision of plantar capsular accessory ossicles

Davies

Dalal

2005

Clin. Anat.

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Bony or cartilaginous ossicles occur at the plantar aspect of the interphalangeal joint of the great toe. The variation in pattern, prevalence, and anatomic relationships of these structures is not clearly established in the literature, especially in a Caucasian population. Without this knowledge, pathology at this joint may be underestimated and surgical approaches may be poorly planned particularly as radiographs underestimate the incidence of ossicles at this joint. The aims of this study were to determine the incidence and pattern of ossicles at this joint and to establish their anatomic relationships to aid planning the approach for their excision. The interphalangeal joint of the left hallux was dissected in 40 British Caucasian cadavers and the pattern of nodules and their anatomic relationships were established. In 27.5% of subjects, there was no identifiable ossicle and, in these specimens, the tendon of flexor hallucis longus was adherent to the joint capsule. In the remaining specimens (72.5%), a bursa separated the tendon of flexor hallucis longus from the plantar joint capsule and nodules were found embedded within the joint capsule. More than half (52.5%) of the specimens had a single nodule located centrally within the plantar capsule and the remaining 20% had two nodules lying within the capsule. This study shows that a large proportion of the population have either one or two bony or cartilaginous ossicles at this joint. It has also shown that, when present, these structures do not lie within the tendon of flexor hallucis longus and may be most safely excised from a medial approach.

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Section: Discussionmentioning

confidence: 83%

“…Previous work from our hospital (Davies et al, 2003) documented pathology from hitherto undescribed paired ossicles. Clearly, the results of the present study demonstrate that two accessory ossicles occur in a substantial proportion of the British Caucasian population.…”

Section: Discussionmentioning

confidence: 99%

Gross anatomy of the interphalangeal joint of the great toe: Implications for excision of plantar capsular accessory ossicles

Davies

Dalal

2005

Clin. Anat.

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“…The hallucal IP sesamoid has a detrimental effect on the biomechanical functions of the first MTP and hallucal IP joints (Roukis and Hurless, 1997). IP sesamoids may cause painful callosities plantar to the joint or may become incarcerated in a dislocated joint (Davies et al, 2003). The reported frequency for hallucal IP sesamoid varies greatly in Caucasians from 5% (Bizarro, 1921) to as much as 50.6% (Pfitzner, 1892).…”

Section: Sesamoid Bones In Digits Of the Feetmentioning

confidence: 99%

Incidence and ossification of sesamoid bones in the hands and feet: A radiographic study in an Arab population

et al. 2006

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The incidence and ossification of sesamoid bones in the hands and feet were studied in 922 radiographs (400 hands and 522 feet) in an Arab population from Bahrain, 5-83 years of age and consisting of 549 adults (393 men and 156 women) and 373 children (286 boys and 97 girls). All radiographs of the hand and foot in the adult population showed two sesamoid bones in the thumb metacarpophalangeal (MCP) joint and in the hallucal metatarsophalangeal (MTP) joint, respectively. Only 2.3% and 1.5% of hands showed sesamoids at the MCP joints of the middle and ring fingers respectively compared to a reported incidence of 7.1% for each digit in Caucasians. The incidence of sesamoids in the MTP joints of third and fourth toes (0.6% each) and inferior to the hallucal interphalangeal joint (3.1%) is probably the lowest reported so far in the literature. In the hands, ossification commenced first in the thumb sesamoids, at the age of 10 years in females and 11 years in males and was completed by the age of 13 and 14 years, respectively. In the feet, ossification began first in the hallucal sesamoids at the age of 8 years in females and 9 years in males and was completed by the age of 10 years in both sexes. The incidence and ossification of sesamoids in the hands and feet in the Arab population from Bahrain seem to differ considerably from reports in other populations. The clinical significance of our findings is discussed.

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“…According to anatomical studies, a single sesamoid at the hallucal IP joint is present in 52.5% of adults, with a paired sesamoid identified in a further 20% of adults for an overall prevalence rate of 72.5% [21]. We did not identify a case of two sesamoid bones at the hallucal IP joint, and identified only one reported case of this rare finding in the literature [23].…”

Section: Prevalence Of Sesamoids At the Hallucal Mtp And Ip Jointsmentioning

confidence: 81%

Prevalence, morphological variation and ossification of sesamoid bones of the forefoot: a retrospective radiographic study of 8,716 Chinese subjects

et al. 2016

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Background and Aim:Previous studies provided evidence of a genetic basis for the occurrence of sesamoids bone in the foot among different ethnic populations. However, information for the Chinese population has not been previously reported. Therefore, the aim of our study was to determine the distribution, morphological variation and ossification timeline of sesamoid bones of the forefoot in a large sample of the Chinese population. Methods: Antero-posterior (AP) and oblique radiographs of 4,417 left and 4,299 right feet obtained from 8,716 patients in the Hebei province of Northern China, and retrospectively examined for the presence of sesamoid bones, identified as a small oval bone plantar to each metatarsophalangeal (MTP) joint and the first interphalangeal (IP) joint. Results and Conclusions:The prevalence rate of a sesamoid bone associated with the first to fifth MTP joints and the first IP joint was 99.96%, 3.08%, 0.39%, 0.69%, 8.94%, and 59.22%, respectively. Moreover, a morphological variation in hallucal sesamoids was identified in 12.09% of feet, with variations classified into three distinct types according to bone size and the number of ossification centers. Ossification begins in the hallucal MTP and IP joints at approximately 8 years of age, with the final ossification center being evidence for the sesamoid bone of the fourth MTP joint at 28 years of age. Relevance for patients: Our study provides important anatomical data regarding the prevalence of sesamoid bones in the forefoot of a large population of Chinese adult and pediatric patients for use in clinical practice and research in forensic science and anthropology.

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Interphalangeal sesamoid bones of the great toe: An anatomic variant demanding careful scrutiny of radiographs

Cited by 13 publications

References 6 publications

Gross anatomy of the interphalangeal joint of the great toe: Implications for excision of plantar capsular accessory ossicles

Gross anatomy of the interphalangeal joint of the great toe: Implications for excision of plantar capsular accessory ossicles

Incidence and ossification of sesamoid bones in the hands and feet: A radiographic study in an Arab population

Prevalence, morphological variation and ossification of sesamoid bones of the forefoot: a retrospective radiographic study of 8,716 Chinese subjects

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