Brachymetatarsia Causes & Symptoms

If you notice one or more of your toes are significantly shorter than the others, you may have a condition called brachymetatarsia

Luckily, this condition is very treatable. Doctors can fix your toe by conducting certain treatment methods or performing simple surgery to lengthen your toe, so it's good as new and no longer causes you any intense psychological or physical pain. 

Learn more about the possible causes of brachymetatarsia, when you should start seeking treatment, and the possible treatment or surgical methods doctors will pursue to restore your toe to your desired length. 

Causes of Brachymetatarsia

When the growth of one of your five metatarsal bones in your foot closes early, it causes your toe to stop growing early on, resulting in a shorter toe than the rest. Your toe could be just a few centimeters shorter or drastically shorter than the others, depending on the severity of the condition. Brachymetatarsia can occur in both feet and is more likely to affect women. Here are some common causes of brachymetatarsia:

  • Congenital condition 
  • Radiation
  • Tumor
  • Trauma 
  • Previous surgery
  • Infection

When to Seek Treatment for Brachymetatarsia

With brachymetatarsia, you may notice your shorter toe start to rise higher than the others, causing the toes below it to all remain touching. This can keep your toe from touching the ground and carrying its share of your weight as you walk. You may also notice calluses form on your feet or even extra skin growth that starts to harden and cause pain when you move on your foot. When this happens, doctors will recommend simple treatment options like extra padding in the shoe or orthotics in an attempt to stop the pain.


Other Possible Brachymetatarsia Treatment Options

In addition to prescribing orthotics and extra padding in your shoe, there are other conservative treatment methods physicians may use to keep the pain in your foot from worsening. A doctor may prescribe you modified shoes that support the length and angle of your toe. Physicians may also ask you to limit your physical activity by taking time off from any sports or recreational activities that are causing you to regularly apply pressure to your foot. 

Doctors may also apply splints or pads to your foot and toe to take any excess pressure off of the affected area. Anti-inflammatory medication is another common treatment option to help reduce swelling and pain. If the pain in your foot continues, your physician may suggest conducting surgery on the toe to lengthen it. 

Types of Brachymetatarsia Surgery 

When conducting surgery on a shortened toe, doctors will lengthen the metatarsal bone using one of three surgery methods depending on the current length of the toe and severity of pain: 

  • Bone-graft lengthening surgery: If your toe is shorter than your other toes by only a centimeter or less, then this type of surgery is necessary. This method is usually complete after one procedure. The surgeon will insert a bone graft inside the metatarsal bone. Physicians often collect bone graft from your heel bone and apply it to the toe they're lengthening. Once they insert it, the surgeons will stabilize your foot by putting screws and a plate in your foot. 
  • Brachymetatarsia external fixator lengthening: This method takes longer than most as it involves stretching or growing your bone to the appropriate length after the surgery. During the surgical procedure, the surgeon may carefully cut the bone and add an external fixator to your bone segments. The external fixator works to stretch your toe's bone over time. It's then your responsibility as the patient to rotate the device certain times during the day to grow your toe's bone slowly until it reaches the desired length. 
  • Sliding bone-cut lengthening: This is usually the least common procedure doctors will perform and is typically only used for minor cases. Surgeons will carefully make an angled cut to the metatarsal bone to lengthen it by shifting the other cut bones onto each other. The surgeons will then hold it in place with screws or metal plates. 

How Long Does it Take to Recover from Brachymestatarsia Surgery? 

Depending on the type of surgery you received and how much lengthening your toe needs, the amount of time it takes for you to recover will vary. Patients typically need around five to eight weeks to recover, while others may need around three months. If you received external fixator lengthening surgery, some doctors may put your foot in a cast if it's having a difficult time healing. 

The best way to recover from surgery and let your foot properly heal is by staying away from physical activity on your feet. Factors like smoking, maintaining a poor diet, and age can also affect how well your foot heals after the surgery. While your toe strengthens and mends itself after your lengthening surgery, it may take you around five to eight weeks to start walking on it normally again.  

Post Treatment 

In addition to rotating the external fixator regularly as instructed by your physician, you may also need to attend follow-up visits with your doctor approximately every two weeks. You're typically required to visit your doctor for follow-up appointments after all of the aforementioned foot surgeries. This allows your doctors time to monitor and analyze your toe and foot for any possible complications after surgery. 

If you received external fixator surgery, the doctor will regularly check your foot to ensure the toe is growing properly and at an appropriate speed. If your toe grows too long or the surgeon accidentally over-lengthens your toe, it may experience issues like intense pain, joint stiffness, or secondary deformities. Make sure you're following the instructions of your doctor and any post-treatment directions they provide you to ensure a fast and safe healing process. 

Your Options at Our Podiatry Practice

If you believe you have brachymetatarsia and are experiencing psychological pain or physical pain in your foot because of it, contact our team today to receive expert podiatric care. Dr. Schoene will closely examine your foot to determine the best treatment option to heal your foot and properly lengthen your toe.