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Short Toe or Brachymetatarsia

Ever wonder if you were the only one with a short toe on one or both of your feet? Well, you are not alone. Short toes can be caused by many things: prior surgery, injury, a congenitally short toe bone or a short bone behind the toe (called a metatarsal). Regardless of the cause there are treatment options available and you should find a surgeon well versed in the correction of these sometimes complex deformities.
In this blog, I will briefly discuss brachymetatarsia, a common cause of short toes. The word brachymetatarsia loosely means short bone behind the toe. This condition can be caused by many things including trauma, infection, or congenital anomalies. The congenital form of brachymetatarsia occurs much more commonly in females with a rate of about 1/1800 in females compared to a rate of 1/4500 in males and becomes visually obvious at four to 15 years of age.
What are your treatment options? Non-surgically your options include accommodative shoes, pads, or orthotics. Surgically, there are essentially two options.
The first is called an acute correction. This involves obtaining a bone graft from somewhere in your body, usually your hip or heel bone, and placing the graft in your short metatarsal. This is usually held in place by a plate and screws and is usually used for smaller corrections. You are typically nonweightbearing for six to ten weeks while the bone graft incorporates.
A newer technique, usually used for larger corrections, involves a small bone stretching device called an external fixator which is placed percutaneously into your short metatarsal. No bone graft is required and only a small incision is needed to make a bone cut. Over the next several weeks your short metatarsal is lengthened by turning a bolt on the external fixator. This is usually a painless process and you are able to bear weight on your foot with crutches to balance during this process. The external fixator is usually removed six to ten weeks after the procedure depending on the amount of lengthening needed and you may return to shoes shortly after that.
If you have any further questions about brachymetatarsia (short toes) or any other foot or ankle problems please contact our office online at or by phone at (704) 662-3660.

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