Overview
Brachymetatarsia is a condition in which one of the five long bones of the foot (the metatarsals) is abnormally short, resulting in a shortened toe. This condition usually occurs in both feet (i.e., bilaterally) and in the fourth toe. If it affects more than one toe, the condition is called brachymetapody.
Causes
The most common cause of brachymetatarsia is when the growth plate of the bone stops growing too soon. This may be caused from trauma, infection or a genetic predisposition.
Symptoms
During Walking, The weight is normally distributed from the 5th toe to the 4th and so on until it reaches the 1st toe ( big toe). The weight and pressure gets distributed and transferred across the ball of the foot evenly. An abnormally short Metatarsal will disrupt this process . If there is a short 4th metatarsal , this means that the weight distribution goes from 5th toe to 3rd toe and either the 5th or 3rd metatarsal bones bear more weight than usual causing the pain and discomfort i.e. callus on the ball of foot.
Treatment
The treatment for brachymetatarsia is very limited. Conservative treatment includes shoe modification ( more room in the toe box area) . Padding of the shoe to relieve pain in the high pressure area . Orthosis may be used to distribute the weigh to other bones.
Surgical treatment is performed to lengthen the bone to its ideal length. This is done by surgically cutting the bone and either 1. Grafting a bone between the two ends 2.Putting a device on the bone to lengthen the bone gradually ( my preferred method).
I like the lengthening method because it give the surgeon more control of how much he/she can lengthen the bone. I usually have the patient lengthen the bone 1/2 mm a day which is done by turning a screw at home ( this process is totally pain free).
Problem with method #1: If the bone needs significant lengthening and the surgeon tries to graft a bone that is too long ,the tendons, arteries and veins might not cooperate. This will result in lost of blood supply to the bone and eventually loosing the toe.
Filed under: Foot & Ankle Sports Injuries Tagged: | bone forming, brachymetatarsia, callus, callus distraction, corn, external fixation, Illizarov, minirail fixator, shoet metatarsal, short foot bone, short toe
Woa my foot looks exactly like that with the same fixator! I still have it on. I had the surgery Sept 15 so its taking about 3 months in total…I’m hoping I get it off soon. How long did it take you from the time you stopped turning to when you got the device off?
It takes about 4-6 weeks after you stop turning for it to consolidate (harden), But there is a dynamization period and your doctor will tell you that . usually a week or two before removing the hardware