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Brachymetatarsia Surgery – Pros And Cons Of It

Brachymetatarsia is a disorder in which a bone in the foot grows abnormally, resulting in a small toe.

The most frequent is a short fourth toe.

However, it may affect any toe.

The toe usually is of average length, but the bone to which the toe connects in the arch (metatarsal bone) is short.

Brachymetatarsia surgery aims to restore the proper length of the metatarsal bone using an osteotomy (bone cutting) and either progressive or abrupt lengthening.

Surgical management is an essential component of patient care.

There are two practical options: gradual lengthening by progressive callotosis distraction with an external fixator or one-stage lengthening via bone transplant and osteotomy of the bone.

What Is Brachymetatarsia?

Brachymetatarsia is a foot ailment that affects the metatarsal bones.

The fourth metatarsal is the most often affected.

Looking at the foot, the injured toe seems to be short.

This disorder may affect both or just one foot and is more frequent in women than males.

Brachymetatarsia symptoms include discomfort while walking on the sole of the feet owing to incorrect weight distribution on the front of the foot.

Furthermore, the short toe often rides high and scrapes on the top of the shoe.

Patients may also complain of callus formation on the bottom of their feet.

Certain people may be embarrassed by the ailment because of its appearance.

Many persons with brachymetatarsia avoid swimming pools and beaches, as well as wearing flip-flops and open sandals.

Causes Of Brachymetatarsia

The most prevalent reason is hereditary, although trauma may also play a role.

A short toe is a growth deformity, not a congenital condition.

It affects women more than men.

People with Psuedophypoparthyroidism or Down syndrome may develop brachymetatarsia.

The foot has five metatarsals, with the fourth metatarsal being the most usually implicated.

Multiple metatarsals may be impacted in certain patients.

It might happen in one or both feet.

Some patients with brachymetatarsia of the foot may also have it in their hands.

The metatarsal bone development is usually inhibited in brachymetatarsia, although the surrounding bone grows appropriately. It is most often seen in early infancy during bone formation.

Brachymetatarsia Surgery Procedure

Toe lengthening is based on restoring length to the short bone. Many approaches have been described, but three are now in use.

  • Sliding Bone-cut lengthening: This is only done in minor circumstances. It entails making a particularly angled or orientated incision in the metatarsal bone to tend the bone by moving the sliced bones onto one another. Because just a little amount of length may be achieved and most brachymetatarsal issues need more sophisticated methods, sliding bone cut lengthening is the least common.
  • Bone-graft lengthening: A typical ONE-STAGE surgery involves putting a structural bone graft into the short bone to increase toe length. The length of the bone transplant is used to assess its size. There is, however, a limit to how much length may be acquired using this strategy. Dr. Blitz would usually consider this approach for toes requiring less than one centimeter of lengthening and involvement. A bone plate and screws that remain in the foot support the bone transplant. Dr. Blitz often uses a bone transplant from the patient's heel bone.
  • External Fixator Brachymetatarsia Lengthening: Consider this a bone stretching or growth technique. This is a standard method for gaining any amount of bone length. Dr. Blitz conducts a precise bone incision (metatarsal corticotomy) to retain the blood flow. An external fixator is placed on the bone segments to stretch the bone apart over time. The patient rotates the device four times each day to gradually develop the bone until the desired length is attained, at which point the fixator is removed.
Multiple doctors performing surgery on a patient
Multiple doctors performing surgery on a patient

Brachymetatarsia Surgery Risks

Shirt toe lengthening surgery, like any other surgery, carries hazards.

Complications may arise with any operation and are not always your or your surgeon's fault.

Nonetheless, you should be aware of the dangers.

Infection, pain (temporary or permanent), swelling, hematoma, bleeding, blood clot, poor wound healing, incision breakdown, poor bone healing (delayed union, nonunion), nerve injury, disability, recurrence, scarring, stiffness, weakness, hardware problems, need for revisional surgery, and catastrophic loss are all possible complications.

Brachymetatarsia Surgery Recovery Time

The amount of shortening that must be treated and the kind of surgery influence recovery following brachymetatarsia surgery.

The minimum period is usually two months.

Significant faults requiring an external fixator may take up to three months to cast.

Age, smoking, poor dietary conditions, and various medical concerns may delay recovery.

People Also Ask

Is Brachymetatarsia A Birth Defect?

Brachymetatarsia is a condition in which one or more toe bones are unusually short or overlapping (metatarsals).

This condition may result from a congenital deficiency or an acquired ailment.

The fourth metatarsal is the most often involved.

When Can I Walk After Brachymetatarsia Surgery?

In most situations, patients are non-weight bearing (or heel touch) weight bearing for at least 6-8 weeks and up to 3 months.

Can You Fix Brachymetatarsia Without Surgery?

Wearing customized shoes that give greater space for the shortened toe that tends to slip upwards is a conservative therapy for brachymetatarsia.

Padding is employed to shield the toe from the top of the shoe, and customized orthotics may be used to reduce pressure on the other toes.

How Long Does It Take To Recover From Brachymetatarsia Surgery?

The minimum period is usually two months.

Significant faults requiring an external fixator may take up to three months to cast.

Age, smoking, poor dietary conditions, and various medical concerns may delay recovery.

Conclusion

Brachymetatarsia may be treated conservatively or surgically.

Wearing accommodating shoes is a conservative solution but does not address the aesthetic problem.

There are two surgical therapies described: progressive lengthening by callotosis and one stage lengthening.

There is no agreement on surgical management since each therapy has merits and downsides.

About The Authors

Suleman Shah

Suleman Shah - Suleman Shah is a researcher and freelance writer. As a researcher, he has worked with MNS University of Agriculture, Multan (Pakistan) and Texas A & M University (USA). He regularly writes science articles and blogs for science news website immersse.com and open access publishers OA Publishing London and Scientific Times. He loves to keep himself updated on scientific developments and convert these developments into everyday language to update the readers about the developments in the scientific era. His primary research focus is Plant sciences, and he contributed to this field by publishing his research in scientific journals and presenting his work at many Conferences. Shah graduated from the University of Agriculture Faisalabad (Pakistan) and started his professional carrier with Jaffer Agro Services and later with the Agriculture Department of the Government of Pakistan. His research interest compelled and attracted him to proceed with his carrier in Plant sciences research. So, he started his Ph.D. in Soil Science at MNS University of Agriculture Multan (Pakistan). Later, he started working as a visiting scholar with Texas A&M University (USA). Shah’s experience with big Open Excess publishers like Springers, Frontiers, MDPI, etc., testified to his belief in Open Access as a barrier-removing mechanism between researchers and the readers of their research. Shah believes that Open Access is revolutionizing the publication process and benefitting research in all fields.

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