Asymmetric bifurcation of the extensor digitorum longus tendon in a case of congenital digitus minimus varus.

Congenital digitus minimus varus (overlapping of the fifth toe) is often bilateral and may result from an anatomic deformity of the extensor digitorum longus tendon. Although bifurcation of the tendinous slip to the fifth toe has been reported as an anatomical variant, in those patients affected with overlapping fifth toe, a pronounced asymmetry between the medial and lateral components may occur. Not only do the two slips to the fifth toe differ in girth, but the morphology of the separate tissues reflects a dissimilar level of organization. Surgical techniques for correction of secondary overlap should consider the possibility of altered gross and histologic anatomy of the extensor tendon when attempting to preserve function.