Foot health influences your ability to walk, run, jump, and perform everyday tasks. Although rare, conditions like brachymetatarsia can lead to physical discomfort and cosmetic concerns. Fortunately, surgical procedures offer an effective, long-lasting solution to this problem. In this article, you will learn what brachymetatarsia is and what to expect from brachymetatarsia surgery.
What Is Brachymetatarsia?
Brachymetatarsia is a condition in which one of the metatarsal bones in the foot (in most cases, the fourth metatarsal) is far shorter than the rest. This can negatively impact the mechanics of the affected toe and influence the way a person walks due to increased pressure on other parts of the foot.
This is a relatively rare condition, with an estimated occurrence rate of 0.022% to 0.05% in the general population. Brachymetatarsia is more prevalent in females than males, with a ratio of 25:1. For some patients, especially younger ones, brachymetatarsia can lead to cosmetic concerns that may challenge their self-esteem. While brachymetatarsia is uncommon, it can occur in both feet during childhood or adolescence.
Causes and Symptoms
Brachymetatarsia can be congenital (present at birth) or acquired (caused by an injury, infection, or medical condition).
Common symptoms of brachymetatarsia include:
- A noticeably short toe
- Discomfort or pain when walking
- Calluses or corns from pressure
- Difficulty fitting in regular shoes
- Changes in gait
Although brachymetatarsia does not typically cause pain, the cosmetic concerns and discomfort associated with the condition often lead individuals to seek treatment.
What Is Brachymetatarsia Surgery?
Brachymetatarsia surgery is a corrective procedure that lengthens the short metatarsal bone. This surgery can restore the natural foot position, improve function, and enhance aesthetics. It may be recommended if conservative treatment is unsuccessful.
The benefits of brachymetatarsia surgery include:
- Improved foot appearance
- Enhanced ability to run and walk
- Decreased pressure on adjacent toes
- Increased confidence wearing open-toed shoes
- Better weight distribution throughout the foot
- Long-term relief from pain and cosmetic concerns
How Does Brachymetatarsia Surgery Work?
Surgical treatment for brachymetatarsia involves a series of steps taken prior to, during, and after the procedure to ensure an optimal outcome.
Pre-Surgical Evaluation
Prior to the surgical procedure, a surgeon will perform an extensive pre-operative evaluation, which may include:
- X-rays or imaging scans to assess bone structure
- Physical examination to assess gait and foot mechanics
- Confirmation of patient goals and expectations
- Medical history review
- Education on the risks and benefits of the procedure
This step ensures that the patient is a suitable candidate for surgery and helps the surgeon tailor their treatment plan.
Surgical Techniques
A surgeon will use one of two techniques to lengthen the short metatarsal bone:
Acute Lengthening:
A bone graft will be used to lengthen the metatarsal bone and affixed with surgical plates, screws, or a pin. It usually takes three months to recover from this procedure, which is best for those who require minimal lengthening.
Gradual Lengthening:
With this method, a controlled cut is made to the shortened bone. Then, an external fixator device is applied to the toe and used to stretch the bone slowly over a period of weeks or months. This technique is used for cases that require more than 15 mm of lengthening.
Post-Surgical Recovery
The recovery process will vary depending on the surgical procedure a patient undergoes, but in general, patients can expect the following:
- Temporary immobilization with a cast or splint
- Routine check-ins to monitor healing progress
- Physical therapy to restore strength and mobility
- Pain medication and ice therapy to manage discomfort
- Temporary abstinence from sports and strenuous activities
Full recovery can take anywhere from three to six months or longer. That being said, long-term recovery is dependent on how well you follow your surgeon’s instructions for post-operative care.
Risks and Complications of Brachymetatarsia Surgery
Like any surgical procedure, brachymetatarsia surgery can result in complications. Possible complications include:
- Infection at the surgical site
- Nerve damage
- Non-union of the bone
- Prolonged swelling and stiffness
- Over-lengthening or under-lengthening of the bone
- Persistent pain
Choosing a reliable surgeon to perform the procedure can lower the risk of certain complications and increase your chances of achieving a positive outcome.
Non-Surgical Treatment for Brachymetatarsia
Surgery for brachymetatarsia is often the most effective treatment option; however, non-surgical treatment may be suitable for mild cases or for patients who are not concerned by the cosmetic aspect of their condition. Non-surgical treatment options include:
- Custom orthotics that help redistribute pressure on the toes
- Padding to prevent the short toe from rubbing against the top of your shoe
- Physical therapy for improved foot function
Non-surgical treatment does not address the bone deformity directly, but it can help manage symptoms and may be recommended while you await surgery.
Contact Dr. Gary Driver for Brachymetatarsia Surgery
If brachymetatarsia is affecting your comfort and confidence, you should take action. Surgery for brachymetatarsia can provide long-lasting improvements to function and appearance. Fellowship-trained foot and ankle surgeon Dr. Gary Driver offers gradual and acute lengthening for brachymetatarsia. With a patient-first approach, you can count on him to provide you with personalized care. Schedule an appointment today and take your first step towards restoring your foot health!
Frequently Asked Questions
How long does recovery take after brachymetatarsia surgery?
Recovery from brachymetatarsia surgery takes several months. Recovery times may vary depending on the surgical technique. If you opt for gradual lengthening, recovery may take longer since the bone will need to consolidate. Most patients are able to return to their daily activities within three to four months.
Is brachymetatarsia surgery covered by insurance?
Your coverage will depend on your insurance provider and the medical necessity of the procedure. We recommend contacting your insurance company for more information.
Can brachymetatarsia return after surgery?
If the bone heals properly after surgery, the condition will not return. However, complications like incomplete healing may require further surgical intervention. Post-surgical follow-ups are essential to ensuring that the bone is healing as expected.
How do I know if I need brachymetatarsia surgery?
You may need surgery if you experience pain while walking that does not improve with orthotics or if you feel emotionally distressed by the appearance of your foot.
