What Is A Short Toe (Brachymetarsia)?
A short toe (Brachymetatarsia) is characterized by one or more metatarsal bones in the foot being shorter than usual, due to a growth disturbance. It usually affects the fourth metatarsal bone, though it could affect any toe. The toe itself has usually normal length, but the bone the toe attaches to in the arch, is short.
Symptoms range from mild to severe pain on the bottom of the foot, but most people feel nothing at all.
It is more commonly seen in women than men.
Causes Of A Short Toe
Hereditary is the most common cause, or it may be an acquired condition resulting from trauma, injury or illness. A short toe may occur in people with Psuedophypoparthyroidism. Also in people with Aarskog syndrome, Apert syndrome and Down syndrome, which can halt the metatarsal bones from fully developing.
This condition affects mostly the fourth metatarsal. But it can affects more than one metatarsals. It occurs in one foot or both feet.
Typically with brachymetatarsia, the metatarsal bone is undergrown while the surrounding bone grows normally. It is usually first noticed in early childhood, when the bones are developing.
A short toe (or toes) is often appearing significantly shorter than the others. Depending on the severity of the short toe, pain may be also a symptom. The deformity can modify the weight distribution of the ball of the foot, causing pain and pressure calluses.
It‘s usually the fourth toe that appears much shorter that the rest of the toes on the foot. Sometimes, it sits higher up on the foot and can get irritated in shoes.
Furthermore, having a short toe is almost always embarrassing. Patients with this condition tend to hide their feet and avoid being barefoot.
Short Toe Lengthening Surgery
If a patient would like to treat brachymetatarsia for cosmetic or medical reasons, metatarsal lengthening surgery is an option.
The procedure for toe lengthening involves restoring the length to the short bone. There are many methods, however today doctors use three techniques:
Sliding Bone-cut Lengthening: This is ideal only for very mild cases; only a small amount of length can be gained, so is the least performed type of surgery. It involves creating a specially angle cut in the metatarsal bone to lengthening the bone by shifting the cut bones onto one another.
Bone-graft Lengthening: This procedure often includes cutting the short metatarsal bone and grafting a piece of bone, from another part of the body, between the two ends.
The doctor stabilizes the bone graft by using a bone plate and screws that stay in the foot. The amount of lengthening determinates the bone graft size.
Though, with this method there’s lengthening amount limitation as well. It suits to patients who need less than one centimeter of lengthening.
External Fixator Lengthening: This is a popular approach to gain any amount of length to the bone. The doctor makes a precise bone cut that preserves the blood supply. Next, he attaches to the bone segments an external fixator. This fixator contains a screw that turns to gradually lengthen the bone. The patient turns the device 4 times per day to slowly grow the bone until it reaches the proper length. Then the doctor removes the fixator.