Brachymetatarsia

Brachymetatarsia is a condition in which one of the five metatarsals (long bones) in the foot appears shortened. This condition will usually occur in the 4th toes of both feet. If shortening occurs in more than one toe, it is referred to as brachymetapody.

Causes of Brachymetatarsia

Brachymetatarsia occurs when the growth plate to the metatarsal closes prematurely and prevents the bone from growing. The result of this condition is an abnormally shortened toe. Genetic factors and traumatic injury could both be attributed to causing brachymetatarsia. Any injury that would permanently damage the growth plate of the metatarsal would prevent further elongation or growth of the toe.

With brachymetatarsia, the normal way of walking is affected. In normal gait (the way we walk) if the 4th toe is abnormally short, then the toe will tend to drift upward and cause the 3rd and 5th toes to receive excess weight since it is too short to hold the intended weight, causing the pain and discomfort in those areas. The positioning of the 4th toe as it rises upward will also make it difficult to accommodate in shoegear and problems will begin to occur.

Treatment of Brachymetatarsia

Conservative treatment for brachymetatarsia can include wearing shoes with increased depth to allow for the upward positioning of the shortened toe. Extra padding to the top of the shoes can prevent any excess pressure and friction that may lead to future ulceration's. Orthotics and inserts can also be used to take the pressure off of the other toes.

Surgery is another option for patients with brachymetatarsia. In this procedure, the shortened bone would have to be cut and a graft would be inserted between the two ends of the cut bone. This will lengthen the toe. In addition to fixing the bone itself, the tendons on top of the toes will have to be lengthened to accommodate for this change.

If the shortened metatarsal is extremely short, and grafting is impossible, then the two adjacent to it may be shortened to assist with the distribution of pressure and allow the foot to transfer weight more appropriately.

After surgery, absolutely no weight should be placed on the operated foot for 3 months, and then the patient will need to wear protective shoegear with support such as a lace-up sneaker or oxford.

Newer treatment can also be used to address brachymetatarsia. This entails fixating an external device that will slowly lengthen the toe to the desired length.

This material is only provided as helpful information and you should always go to your medical doctor or podiatrist for a professional diagnosis.