This condition develops when the growth plate closes early. Any of the five metatarsal bones may be affected. However, the most common is the 4th metatarsal. Also, this condition usually occurs on both feet. During childhood, the growth plate closes early. The other metatarsals continue to grow leaving a short metatarsal. Brachymetatarsia may also create a condition known as “metatarsalgia.”
Metatarsalgia is a general term for painful metatarsal. Increased pressure from decreased fatpad, worn shoes, walking on hard surfaces, or a foot injury may also create metatarsalgia. The metatarsals evenly support your weight on the ball of the foot. When one or more metatarsal are “lower” to the ground than the others, the increased weight can create this condition. In Brachymetatarsia, the short metatarsal has a reduced amount of weight. This weight is therefore transferred to the adjacent metatarsals. One of the signs of a “dropped” metatarsal is a callus (see Corns/Calluses).
Treatment for Brachymetatarsia is limited. Orthotics and good fitting shoes can alleviate any pain that may occur. However the conservative approach can not remove any psychological problems that may arise from this deformity. Many individuals with this condition are reluctant to display their feet at the pool or any other social environments. There are 2 methods to correct the problem as an adult. The first uses an external device known as a “distracter.” This device “grows” bone over a period of time. The goal is to provide a normal looking foot with a normal lengthened and functional metatarsal bone. The second method uses a bone graft which requires internal fixation and lengthening of the tendons. The problem of squeezing the blood supply in this method is a concern. Combining the 2 methods is also an option. However, the first option has a high success rate on its own. This method stretches the tendons, nerves and blood vessels over a period of time. This also allows those structures to conform to the new length.
