Brachymetatarsia is due to a congenital event or trauma to the growth plate, which causes an abnormally short metatarsal. Brachymetatarsia causes the toe to stick up in the air and rub on shoes. Patients biggest complaint is often the aesthetic appearance of having a toe that is not in the correct position. This condition usually involves the fourth metatarsal, however, it can appear in any metatarsal.
Toes that are abnormal in length and in the wrong position are commonly associated with pain and embarrassment. Patients with short toes tend to hide their feet and avoid being barefoot, which may cause self-confidence issues in kids. The fourth toe usually sits higher up on the foot and can get irritated in shoes. Also, the condition causes imbalance weight distribution to the ball of the foot, which can cause pain and calluses.
Conservative care for brachymetatarsia consists of wearing wider shoes with arch support, reduced activities, wearing custom-molded orthotics, and stretching shoes. Permanent solutions for brachymetatarsia condition consist of surgery, where the metatarsal is lengthened through external fixation, bone graft, or a sliding bone cut. Callostasis is the process where you can lengthen a bone using an external fixator. Seven days after surgery the patient will turn their external fixator four times a day to lengthen the metatarsal by 1 mm a day. Bone can be distracted approximately 10-15 mm throughout the course of surgery. Lengthening the metatarsal will help re-align the parabola of the metatarsal head and re-distribute the pressure. Conditions like these fit our exact motto: walk with comfort and look great doing it or saving the world one foot at a time.
Our board-certified doctors have experience treating all pediatric conditions of the foot and ankle and will make sure your kids are in good hands. Dr. Gold has been to medical missions in El Salvador treating clubfeet, equinus, and pediatric flat feet.