Brachymetatarsia

Abstract

Brachymetatarsia is a rare clinical entity that presents a complicated case to the treating surgeon. One-stage lengthening procedures with a variety of biologic and synthetic implants are preferred for metatarsals that only need to be lengthened up to 15 mm, whereas gradual lengthening allows for greater length gain and concomitant lengthening of the soft tissues. Adjacent metatarsal shortening may be used in conjunction with lengthening procedures to restore the parabolic arc of the metatarsal heads. Management should be tailored to the patient's individual deformity and expectations. Individualization of surgical techniques and patient selection criteria can result in a cosmetic, functional result that is satisfactory to the clinician and the patient.

One-stage Metatarsal Lengthening by Allograft Interposition: A Novel Approach for Congenital Brachymetatarsia

“…The acquired etiology refers to traumas, neurotrophic disorders, poliomyelitis, and surgery during growing age [19,23,30,35]. The deformity is not usually present at birth but becomes clinically manifest usually after 4 years of age [28].…”

“…In addition, many patients, particularly young women, complain of the appearance [8,17,21,28,34,35]. Other toe deformities often are associated: the toes of the normal rays may be deviated to fill the gap formed by the involved toe: the toes placed medially are deformed in valgus, whereas the toes placed laterally are deformed in varus (Fig.…”

“…Patients with brachymetatarsia complain of metatarsalgia, calluses, shoe wear irritation, and soft tissue contractures [1,3,28]. In addition, many patients, particularly young women, complain of the appearance [8,17,21,28,34,35].…”

“…It is a rare deformity, the incidence of which is reported as ranging from 0.02% to 0.05% [28,29], with a clear female preponderance of 25:1 [28]. This deformity can be unilateral or bilateral, and any of the five metatarsals can be affected [23,25,27,33], although the fourth metatarsal is the most frequently involved.…”

Does Greek Foot Predispose to Morton’s Neuroma?

“…This results in a hallux that appears to be shorter than the second phalanx and is a common type of brachymetatarsia [33]. Greek Foot was originally known as Morton's Foot after the surgeon Dudley Morton who described the variant as Metatarsus atavicus, and reported its prevalence as 10% of the population [34].…”