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Brachymetatarsia is a deformity of the metatarsals.
The metatarsal will be shorter then rest. Regardless of the length, short metatarsal will eventually become symptomatic.
Whether it be metatarsalgia, neuritis, transfer lesions, capsulitis or a cocked-up toe, dislocated MPJ, symptoms will occur.
There
is no reason to ever correct this deformity until it is symptomatic. Pure cosmetic corrections will ultimately fail. Surgery
is stressful and painful and should only be performed for function. Cosmesis is only the icing on the cake.
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Typical short 4th metatarsal with cocked up 4th toe
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Typical xray showing the short metatarsal
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Typical case from start to finish
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Via gradual distraction, the metatarsal is lengthened .5mm/day until the desired length is achieved
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Once length has been achieved, the ex-fix needs to stay on to allow for consolidation of the new
bone growth
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Unlike lesser metatarsals, 1st metatarsal needs to NOT be lengthened to radiographic length. Lengthen
until the symptoms (metatarsalgia) resolves. In general it will be half as far you would think it needs to be.
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Symptoms resolved after 5mm of lengthening
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Now this is a rare case, double brachymets
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Via the miracle of callostasis (gradual distraction), look at the final results
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The clinical results are truely awesome. This case was treated by William Healey, DPM at Ft. Bragg.
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