When is a toe a thumb?

I was casually surfing the web looking for interesting articles about medicine that were possibly foot related, when I came across one that peaked my interest. It was from the UAB News dated 09/19/2011 written by Tyler Green.
 http://www.uab.edu/news/reporter/people/item/1646-toe-thumb-transplant-gives-patient’s-active-lifestyle-a-boost .

As I began to read this article, my mind started to process this from a podiatric point of view. I was hoping that in performing a toe-thumb transplant, they didn't perform this using the great toe. I was greatly relieved to learn that Dr. Long used the 2nd toe for the transplantation. The great toe or hallux is an extremely important part in the mechanics of propulsion and walking. There are a numerous muscles and tendons that are connected to the great toe that are of the utmost importance for standing, balance, and gait. If they performed a transplant utilizing the great toe, they would have potentially created two problems:

One, that the foot would not function nearly as well without its supportive base. The big toe is integral for the body to move from step to step. It is the main force that moves you forward. If the big toe is no longer present, then the body naturally shifts towards the outside of the foot. This can cause hammertoes, pain in the ball of foot, and inflammation of the foot tendons.

Secondly, the great toe due to its unusual anatomy would not perform as well in the hand as the second toe could. A thumb's main function is to grasp and hold objects. The second toe is simpler in its anatomy and has the ability to better function as a replacement for thumb function. As far as loss of second toe function in the foot, while it being far from ideal without it, is easier for the foot to adapt.

For more information on foot anatomy and the mechanics of walking, please visit our web site at:
http://www.podiatrycarespecialists.com/

Bradford J. Jacobs, DPM, FACFAS
Alexandra K. Grulke, DPM, FACFAS