Morton's toe

Presentation

The most common symptom experienced due to Morton's toe is callusing 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 and shoes are often too tight on the toes. A tight shoe toe box 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. Wide shoes are recommended.

Treatment

Asymptomatic anatomical variations in feet generally do not need treatment. 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 orthotics can help alleviate numerous problems of the feet such as metatarsalgia, hammer toes, bunions, Morton's neuroma, plantar fasciitis 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%. Another study on the Idoma people of Nigeria found almost a third of people have it.

Etymology

The name derives from American orthopedic surgeon (1884–1960), who originally described it as part of Morton's triad, also known as Morton's syndrome or Morton's foot syndrome.

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 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 also have an increased prevalence of Greek foot), and this persisted as an aesthetic standard through Roman and Renaissance periods and later on in neo-classical works such as on the Statue of Liberty 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, Laocoön and His Sons and Diana of Versailles.

There are also associations found within Celtic 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. Also in German this foot shape is called Griechischer Fuß ("Greek foot") as opposed to Ägyptischer Fuß ("Egyptian foot") where the second toe is shorter and Römischer Fuß ("Roman foot") where hallux and second toe are of equal length.

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.

References

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10. (2014). "Effect of the Intrinsic Foot Muscle Exercise Combined with Interphalangeal Flexion Exercise on Metatarsalgia with Morton's Toe". Journal of Physical Therapy Science.
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13. Aigbogun, Eric Osamudiamwen, et al. "Morton's toe: Prevalence and inheritance pattern among Nigerians." International Journal of Applied and Basic Medical Research 9.2 (2019): 89.
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15. (2012-01-19). "Dr. Dudley Morton, the Father of the Morton's Toe".
16. (1903-05-20). "Thomas George Morton".
17. (April 2015). "The Greek Foot: Is it a Myth or Reality? An Epidemiological Study in Greece and Connections to Past and Modern Global History". [[Rheumatology (journal).
18. (2010). "An exploratory study of the relationship between second toe length and androgen-linked behaviors". [[Journal of Social, Evolutionary, and Cultural Psychology]].
19. (2012). "The History of Ancient Art Volumes 1-2". University of Minnesota.
20. (17 August 2022). "Why do many Greek sculptures or Renaissance paintings have people with extra-long second toes". [[Cultura Colectiva]].
21. "The Story Behind the "Greek Foot" and its Medical Explanation". [[Greek Reporter]].
22. (November 2003). "Zur Historie der Civinini-Durlacher-Neuropathie, genannt Morton Metatarsalgie". Fuss & Sprunggelenk.