Morton's toe, also known as Greek toe, is the condition of having a first

metatarsal The metatarsal bones or metatarsus (: metatarsi) are a group of five long bones in the midfoot, located between the tarsal bones (which form the heel and the ankle) and the phalanges ( toes). Lacking individual names, the metatarsal bones are ...

bone that is shorter than the second metatarsal (see diagram). It is a type of brachymetatarsia. This condition is the result of a premature closing of the

first First most commonly refers to: * First, the ordinal form of the number 1 First or 1st may also refer to: Acronyms * Faint Images of the Radio Sky at Twenty-Centimeters, an astronomical survey carried out by the Very Large Array * Far Infrared a ...

metatarsal's growth plate, resulting in a short big toe, giving the second toe the appearance of being long compared to the first toe. The

bones behind the toes are of different lengths, and the relative lengths vary between people. For most feet, a smooth curve can be traced through the joints at the bases of the toes (the metatarsal-phalangeal, or MTP, joints). But in Morton's foot, the line has to bend more sharply to go through the base of the big toe, as shown in the diagram. This is because the first metatarsal, behind the big toe, is short compared to the second metatarsal, next to it. The longer second metatarsal puts the MTP joint at the base of the second toe further forward. If the big toe and the second toe are the same length (as measured from the MTP joint to the tip, including only the toe bones or

phalanges The phalanges (: phalanx ) are digit (anatomy), digital bones in the hands and foot, feet of most vertebrates. In primates, the Thumb, thumbs and Hallux, big toes have two phalanges while the other Digit (anatomy), digits have three phalanges. ...

), then the second toe will protrude farther than the big toe, as shown in the photo. If the second toe is shorter than the big toe, the big toe may still protrude the furthest, or there may be little difference.

Presentation

The most common symptom experienced due to Morton's toe is

callus A callus (: calluses) is an area of thickened and sometimes hardened skin that forms as a response to repeated friction, pressure, or other irritation. Since repeated contact is required, calluses are most often found on the feet and hands, b ...

ing and/or discomfort of the ball of the foot at the base of the second toe. The first metatarsal head (toeward end of the metatarsal, at the base of the big toe) would normally bear the majority of a person's body weight during the propulsive phases of gait, but because the second metatarsal head is farthest forward, the force is transferred there. Pain may also be felt in the arch of the foot, at the ankleward end of the first and second metatarsals. In shoe-wearing cultures, Morton's toe can be problematic. For instance, wearing shoes with a profile that does not accommodate a longer second toe may cause foot pain. A small (80-person) study found no statistically significant difference in the frequency of longer second toes between people with and without ingrown toenails, but tight and ill-fitting shoes are generally considered to increase the risk of ingrown toenails, and shoes are often too tight on the toes. A tight shoe

toe box The toe box is the section of footwear that surrounds the toes on closed-toe shoes. Toe boxes that are too tight can cause injuries and foot deformity, foot deformities, whereas wider toe boxes may be used to treat or prevent common foot condition ...

can also cause hammer toes.

Associated condition

Among the issues associated with Morton's toe is that the weight distribution causes the front of the foot to widen as the weight shifts from the first shortened toe to the others. Regular shoes will often cause metatarsalgia and neuromas as the shoe pushes together the toes hence the case of

Morton's neuroma Morton's neuroma is a benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces (between the second/third and third/fourth metatarsal heads; the first is of the big toe), which results in ...

. Wide shoes are recommended.

Treatment

Asymptomatic Asymptomatic (or clinically silent) is an adjective categorising the medical conditions (i.e., injuries or diseases) that patients carry but without experiencing their symptoms, despite an explicit diagnosis (e.g., a positive medical test). P ...

anatomical variations in feet generally do not need treatment. Conservative treatment for foot pain with Morton's toe may involve exercises or placing a flexible pad under the first toe and metatarsal; an early version of the latter treatment was once patented by Dudley Joy Morton. Restoring the Morton's toe to normal function with

proprioceptive Proprioception ( ) is the sense of self-movement, force, and body position. Proprioception is mediated by proprioceptors, a type of sensory receptor, located within muscles, tendons, and joints. Most animals possess multiple subtypes of propri ...

orthotics Orthotics () is a medical specialty that focuses on the design and application of orthoses, sometimes known as braces, calipers, or splints. An is "an externally applied device used to influence the structural and functional characteristics of ...

can help alleviate numerous problems of the feet such as

metatarsalgia Metatarsalgia, literally 'metatarsal pain' and colloquially known as a stone bruise, is any painful foot condition affecting the metatarsal region of the foot. This is a common problem that can affect the joints and bones of the metatarsals. Me ...

, hammer toes,

bunion A bunion, also known as hallux valgus, is a deformity of the metatarsophalangeal joint, MTP joint connecting the big toe to the foot. The big toe often bends towards the other toes and the joint becomes red and painful. The onset of bunions is ...

plantar fasciitis Plantar fasciitis or plantar heel pain is a disorder of the plantar fascia, which is the connective tissue that supports the Arches of the foot, arch of the foot. It results in pain in the heel and Sole (foot), bottom of the foot that is usuall ...

and general fatigue of the feet. Rare cases of disabling pain are sometimes treated surgically.

Prevalence

Morton's toe is a minority variant of foot shape. Its recorded prevalence varies in different populations, with estimates from 2.95% to 22%. A study by the

Bulgarian Academy of Sciences The Bulgarian Academy of Sciences (abbreviated BAS; , ''Bŭlgarska akademiya na naukite'', abbreviated БАН) is the National Academy of Bulgaria, established in 1869. The Academy, with headquarters in Sofia, is autonomous and consists of a S ...

found that it is far more prevalent among Bulgarians. Another study on the

Idoma people The Idomas are a people that primarily inhabit the lower western areas of Benue State, Nigeria, and some of them can be found in Taraba State, Cross River State, Enugu State, Kogi State and Nasarawa State in Nigeria. The Idoma language is cla ...

of Nigeria found almost a third of people have it.

Etymology

The name derives from American

orthopedic surgeon Orthopedic surgery or orthopedics (American and British English spelling differences, alternative spelling orthopaedics) is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgic ...

Dudley Joy Morton (1884–1960), who originally described it as part of Morton's triad, also known as Morton's syndrome or Morton's foot syndrome. It is a congenital short first metatarsal bone, a hypermobile first metatarsal segment, and

es under the second and third metatarsals. Confusion has arisen from "Morton's foot" being used for a different condition, Morton's metatarsalgia, which affects the space between the bones and is named after Thomas George Morton (1835–1903).

Culture

Morton's toe, especially the second-toe-is-longer versions, has a long association with disputed anthropological and ethnic interpretations. Morton called it ''Metatarsus atavicus'', considering it an

atavism In biology, an atavism is a modification of a biological traits structure or behavior whereby an ancestral genetic trait reappears after having been lost through evolutionary change in previous generations. Atavisms can occur in several ways, ...

recalling prehuman grasping toes. In statuary and shoe fitting, a more-protuberant second toe has been called the Greek foot (as opposed to the Egyptian foot, where the great toe is longer). It was an idealized form in Greek sculpture (hence the common name "Greek toe"; modern Greeks have an increased prevalence of Greek foot), and this persisted as an aesthetic standard through

Roman Roman or Romans most often refers to: *Rome, the capital city of Italy *Ancient Rome, Roman civilization from 8th century BC to 5th century AD *Roman people, the people of Roman civilization *Epistle to the Romans, shortened to Romans, a letter w ...

and

Renaissance The Renaissance ( , ) is a Periodization, period of history and a European cultural movement covering the 15th and 16th centuries. It marked the transition from the Middle Ages to modernity and was characterized by an effort to revive and sur ...

periods and later on in neo-classical works such as on the

Statue of Liberty The Statue of Liberty (''Liberty Enlightening the World''; ) is a colossal neoclassical sculpture on Liberty Island in New York Harbor, within New York City. The copper-clad statue, a gift to the United States from the people of French Thir ...

which has toes of this proportion. Some famous Classical and Renaissance art works featuring Morton's toe include Boxer at Rest,

The Birth of Venus ''The Birth of Venus'' ( ) is a painting by the Italian artist Sandro Botticelli, probably executed in the mid-1480s. It depicts the goddess Venus (mythology), Venus arriving at the shore after her birth, when she had emerged from the sea ful ...

Laocoön and His Sons The statue of ''Laocoön and His Sons'', also called the Laocoön Group (), has been one of the most famous ancient sculptures since it was excavated in Rome in 1506 and put on public display in the Vatican Museums, where it remains today. The st ...

and

Diana of Versailles The ''Diana of Versailles'' or ''Artemis, Goddess of the Hunt'' () is a slightly over-lifesize marble statue of the Roman goddess Diana (mythology), Diana Artemis, (Greek: Artemis) with a deer. It is now in the Musée du Louvre, Paris. The statu ...

. There are also associations found within

Celtic Celtic, Celtics or Keltic may refer to: Language and ethnicity *pertaining to Celts, a collection of Indo-European peoples in Europe and Anatolia **Celts (modern) *Celtic languages **Proto-Celtic language *Celtic music *Celtic nations Sports Foot ...

groups. The French call it commonly ''pied grec'' (just as the Italians call it ''piede greco'', both "Greek foot") but sometimes ''pied ancestral'' or ''pied de Néanderthal''.

References

Sources

* Morton, D. J. "Metatarsus atavicus: the identification of a distinct type of foot disorder", ''The Journal of Bone and Joint Surgery'', Boston, 1927, 9: 531-544.
Toes, relative lengths of first and second
''Online Mendelian Inheritance in Man''.
EFORT – European Federation of National Associations of Orthopaedics and Traumatology
Scientific Library
Concepts of the human foot in mythology, art and surgery
John Kirkup, ''EFORT'' (''Bulletin of European Orthopaedics''), #11, Nov. 1999.
"British feet"
''Discover Magazine'', June, 1996, Retrieved June, 2021. * {{DEFAULTSORT:Morton's Toe Foot diseases Skeletal disorders Toes