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Short Toe / Brachymetatarsia Surgery

Brachymetatarsia is when one of the five toe bones stops growing too soon. When that bone is too short, so is the toe. This condition usually happens in both feet, and mostly on the fourth toe, even though it can affect other bones/toes. Brachymetatarsia is mostly caused by genetic predisposition, but can also be caused by trauma or infection. Conservative treatment for brachymetatarsia may include wearing special shoes with a large toe box. Special padding can help protect the short toe from friction and irritation caused by the shoe. Custom-made orthotics can help relieve pressure and distribute weight to other bones. If those treatments do not work, then bone lengthening surgery is the next option.

Brachymetatarsia (Short Toe) Procedure

Dr. K’s is one of the few surgeons in the country who has experience with bone lengthening.

There are two types of surgery:

If Dr. K decides that a patient is a good candidate for the first type of surgery, he makes a small incision and attaches a bone-stretching device (external fixator) to the short toe bone. Over the next few weeks, the patient gradually and painlessly turns the external fixator (at home) until the toe is gently stretched to the appropriate length.
This works much like braces do when they slowly straighten crooked teeth. This method gives the patient more control of how much he/she can lengthen the bone. During this time period, the patient can stand on their foot with crutches.

If Dr. K decides that the patient is a good candidate for the second type of surgery (one stage bone graft lengthening), he makes a slightly bigger incision, cuts the toe bone in half and places an appropriate size bone graft in between the two halves of the toe bone.

After a few weeks, the bone graft heals and becomes part of the toe bone. This method requires a surgeon, like Dr. K, who is extremely experienced because all the lengthening is done at once and cannot be changed after surgery.