Brachymetatarsia is a condition in which one of the five long bones of the foot (the metatarsals) is abnormally short, resulting in a shortened toe. This condition usually occurs in both feet (i.e., bilaterally) and in the fourth toe. If it affects more than one toe, the condition is called brachymetapody.

Causes of Brachymetatarsia

In most cases, brachymetatarsia results when the metatarsal growth plate closes too early. Once the growth plate closes, the bone can no longer grow. This can be caused by a genetic factor or by trauma to the foot that results in a metatarsal growth plate fracture.

Physiology of Brachymetatarsia

A shortened toe can cause several problems. During walking, the weight normally is transferred from the fifth toe to the fourth, then to the third, and so on until it reaches the first toe (hallux). This occurs because the toes are gradually longer and as weight is transferred to the forefoot, the next longest toe assumes the weight. Brachymetatarsia disrupts this process.

brachymetatarsia2If the fourth toe is shorter than the fifth toe, it never assumes the body weight and cannot transfer it to the third toe correctly. As a result, the fifth and third toes receive extra weight and pain develops in those areas. An abnormally short toe also tends to drift upward, which often causes problems with footwear.

Isolated short toes can be a problem which is aesthetically displeasing and lead to many similar social and functional issues as with excessively long toes. The cause of the condition can be congenital or acquired. Depending on the cause, a procedure can now be performed to improve the aesthetic appearance of the toe and restore its length.

Because no two feet are alike, each patient deserves individualized attention and a procedure geared towards their specific situation and goals may be proposed.