한국인 소아의 두마디뼈 새끼발가락

Abstract

Radiographic research was performed to know the frequency of two-phalanged fifth toe and its relation to presence of the ossification centers in normal Korean children. Previous study showed more than 74% of the incidence in adulthood and less than 30% in childhood. Fifty children (33 male and 17 female, aged 2 to 15; mean age 9.6) were studied by plain foot radiographs focused on the fifth toe. In the 3~8 yr old 20 subjects, secondary ossification center of distal phalangeal bone was seen as a ossicle (small bone) placed at proximal to the distal phalanx. Secondary ossification center of middle phalangeal bone and the bony shaft of the phalanx was hard to distinguish. So keeping up the objectivity, regardless of distinguishable ossification center or the bony shaft of phalanges, ossicles seen on the 5th toe was counted to classify the presumptive type of the toe. Epiphyseal ossification center of proximal phalanx was excluded from the count. There were three types of the fifth toe which has 2 ossicles to 4 ossicles. Overall incidence of the type of 2 ossicles was 24% (12/50). Above 12 yr old group the incidence was 61% (11/18), and above 13 yr old group the incidence was 75% (9/12). The incidence of biphalangism came closer to the adult’s after late childhood. This finding represent that progress of biphalangealization completed after late childhood. It seems that the progress starts earlier than 3 yr old. We made the hypothesis by the incidence of 30% (6/20) of the type which has 4 ossicles on the fifth toe at 3~8 yr old group. Four ossicles might be a secondary ossification center of distal phalanx and the bony shaft of distal, middle and proximal phalanx. They might form a distal interphalageal joint and the triphalangeal toe. To know more about the morphogenesis of biphalalngeal 5th toe, further progressive study in childhood is needed.