The metatarsal bones are the five long bones of the foot located between the ankle and the base of each of the toe bones: numbered from one-to-five (big toe-to pinky toe). 

Brachymetatarsia is a condition that affects a metatarsal bone (typically the fourth), causing it to be shorter than the other metatarsals. This makes that toe markedly shorter than the other toes. Sometimes the toe is pulled back, or raised, or it may overlap another toe. When this condition occurs in more than one metatarsal, it is known as brachymetapody. 

Along with causing an unsightly appearance of the affected toe, brachymetatarsia can negatively affect a person’s gait, and may lead to pain and calluses. It can also make it difficult to find shoes that do not irritate the affected toe.

What Causes Brachymetatarsia?

Brachymetatarsia can occur in one or both feet, and it typically affects more women than men. This condition can be caused by:

Genetics. Brachymetatarsia is often inherited.

Trauma. If a child injuries a metatarsal bone before the bone’s growth plate has closed, normal growth of the bone may become disrupted.

Medical Conditions or Syndromes. Certain genetic conditions or syndromes may cause brachymetatarsia, such as Down syndrome, Turner syndrome, Pseudohypoparathyroidism, Aneuploidic anomalies, and more.

Can Brachymetatarsia Be Treated?

There are conservative techniques your podiatrist may use to treat symptoms, including:

• Modifying footwear to make room for the raised or overlapping toe
• Padding the toe to prevent corns and calluses from forming
• Splinting or strapping the toe to change its position and reduce friction and pressure 
• Custom orthotics to offset pressure and distribute weight across the foot

In some cases, a surgical procedure may be performed to lengthen the metatarsal bone and correct the deformity:

• Single-stage lengthening procedures can be done to insert a bone graft that lengthens the metatarsal bone
• Gradual, or multi-stage lengthening procedures using a very small external fixator can encourage natural growth and lengthening of the metatarsal bone and surrounding tissue

There is no need to live with the pain, imbalance, or embarrassment of brachymetatarsia. Call our office for a full examination and assessment, so we can determine the best way to help your individual situation.