Third toe !
The third toe, the middle toe, has three small bones (phalanges) and helps with balance and grip.
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What it is
The third toe, made of three small bones (phalanges).
What it does
The smaller toes help with balance and grip when you stand and walk.
Key facts
- Joints with
- Third metatarsal (MTP joint); proximal and distal interphalangeal joints
- Landmarks
- Three phalanges; FDL to distal, FDB to middle phalanx; extensor expansion; third dorsal interosseous (lateral), first plantar interosseous (medial); lumbrical
Relations
- Behind
- Third metatarsal head and the plantar plate
- Medial
- Second toe; the first plantar interosseous and the second lumbrical
- Lateral
- Fourth toe; the third web space with the common plantar digital nerve
- Above
- Extensor digitorum longus and extensor digitorum brevis tendons
- Below
- Flexor digitorum longus and flexor digitorum brevis tendons; plantar digital nerves and arteries
How to find it
Its MTP joint is felt behind the web on the dorsum. The skin of its lateral side and of the medial side of the fourth toe is supplied by the third web space nerve.
Examination
- Web space compression: pressing between the third and fourth metatarsal heads reproduces neuroma pain that spreads into the toes
On imaging
Dorsoplantar, oblique and lateral foot views; the lesser toes overlap on the lateral view, so the oblique is the most useful for phalangeal fractures. Radiographs also show the joint positions of claw or hammer toe. A Morton neuroma in the third web space is not seen on radiographs; ultrasound or MRI shows it as a small mass between the third and fourth metatarsal heads.
Common problems
- Hammer toe or claw toe: the toe bends up at the base and down at the middle joint, often with corns.
- Fractures from stubbing or dropping something on the toe.
Clinical notes
- Claw toes affecting several lesser toes together suggest a neurological cause such as diabetic neuropathy or Charcot–Marie–Tooth disease
- The common digital nerve of the third web space classically receives fibres from both the medial and lateral plantar nerves, one explanation for neuroma here
Development
Its three phalanges are first modelled in cartilage; each then ossifies from a primary centre in the shaft and just one secondary centre, so each phalanx has a single growth plate.
Memory aid
PAD and DAB: Plantar interossei ADduct, Dorsal interossei ABduct; in the foot the axis runs through the second toe.
Related conditions
Test yourself
Think of the answer, then tap the question to see it.
How do claw toe, hammer toe and mallet toe differ?
Claw: MTP extended, both interphalangeal joints bent; hammer: proximal interphalangeal joint bent; mallet: distal joint bent.
Numbness on the facing sides of the third and fourth toes suggests what?
A Morton neuroma in the third web space.
Why does the third toe have a plantar interosseous on its medial side?
In the foot the axis for toe abduction and adduction runs through the second toe.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- digitus tertius pedis; phalanges pedis TA2 173
- Official Spanish (DeCS)
- Tercer dedo del pie DeCS D014034
- English (TA2)
- Third toe
- Also called
- third digit of foot · digit 3 of foot · phalangeal bones of foot
Related
- Third metatarsal
- Toe arteries
- Toe extensor tendons
- Flexor digitorum brevis
- Toe flexor tendon
- MTP ligaments and plantar plate
- Plantar interossei
- Toe joint capsules
Sources: Terminologia Anatomica (TA2); DeCS; Anatomy, Bony Pelvis and Lower Limb: Foot and Ankle; 8.5 Development of the Appendicular Skeleton (OpenStax (Rice University), 2022) · adapted, CC BY 4.0.
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Representative model, for educational purposes only.
