For a small subset of people, one of their toes may actually be smaller and shorter than their pinky toe. Oftentimes this occurs on the toe adjacent to the pinky, but it can happen to other toes as well. This condition is known as brachymetatarsia, and involves an early closure of the growth plate in the toe. Below, we take a closer look at brachymetatarsia and how a foot specialist can help you treat the issue.
Causes And Symptoms Of Brachymetatarsia
As we mentioned, above, brachymetatarsia involves the premature closure of a growth plate in the toe. Oftentimes it is simply a congenital issue, but the deformity can also be the result of trauma, infection, tumor, radiation treatment or a prior surgery in the area. Interestingly, brachymetatarsia is much more common in women than in men, as it’s 25 times more likely in women.
Aside from the visible deformity, someone with brachymetatarsia may experience pain and discomfort in the area, as well as difficulty walking as a result of the shortened toe. Some patients may also be self-conscious or have other psychological effects associated with a significantly shorter toe. Physical symptoms tend to get more noticeable as the person gets older, but a foot specialist can help walk you through some treatment options.
Diagnosis And Treatment
Diagnosing brachymetatarsia is pretty straight forward, and while your doctor can diagnose the condition with the help of a physical exam, an imaging test like an x-ray is typically ordered to see exactly how the bones have formed, as this can help with treatment protocols.
Treatment will depend on the current symptoms, how the foot specialist believes the condition will progress, and the expected treatment outcomes, as both conservative and operative options are available. In cases where the deformity is minor or causing minimal issues, conservative approaches may be all that are needed. Comfortable shoes with a wider toe box can help protect the area, as can avoiding certain high-impact activities.
If surgery is determined to be the optimal route, you may move forward with one of two options depending on you scenario. There are:
Bone Grafts – In this operation, the metatarsal is cut and lengthened, with a bone graft inserted into the newly created space. A plate and screws or similar hardware is used to keep the graft in place while the bone heals. Most patients will need to be non-weight bearing for at least eight weeks following this procedure. A bone graft is typically collected from the patient’s heel area to create this graft, which increases the likelihood of a successful grafting process.
External Fixation – This approach involves cutting the bone and lengthening it using a technique called bone callus distraction. A small cut is made on the metatarsal while preserving local blood supply, and then a mini external fixator is applied. About a week after the surgery, the patient will gradually adjust a device on the outside of their foot that will painlessly and gradually lengthen the metatarsal. Lengthening typically occurs at about 1mm a day until the desired length is achieved, typically around the 4-6 week mark. The fixator remains in place after this period while the bone heals, and eventually it is removed by the surgeon after enough healing has occurred.