Brachymetatarsia is a condition in which one or more of the metatarsal bones is abnormally short. This can be a congenital condition or acquired if any injury or trauma occurs while the growth plates are open.
Not only can this condition cause cosmetic concern but it can also cause pain and affect the way one walks.
The toe that is part of this metatarsal shortening is shorter in appearance and can contract dorsally, causing rubbing and irritation in shoes.
This condition most commonly affects the 4th metatarsal and is more common in women. It can cause abnormal pressure distribution in the ball of the foot causing pain and difficulty with walking. It can also be difficult finding regular shoes to wear.
Conservative Treatment Options
- Custom orthotics with areas to help support or offload the affected area
- Good shoes with wide toe box area
- Padding
- NSAIDs
- Alter physical activity level
What If Treatments Don't Work?
If conservative treatments fail, referral for surgery may be recommended. With surgical intervention, the affected shortened metatarsal is exposed and cut towards the base of the metatarsal where there is good blood supply.
Then an external fixator device is placed with a pin on each side of the bone cut and this is used to grow the bone out to length over time until desired length is achieved. This typically requires a non-weightbearing period of up to 6-8 weeks. Typically this procedure brings the entire ray, the metatarsal and toe, out to length and physical appearance and function is improved.