Brachymetatarsia

Brachymetatarsia (a.k.a. congenital short metatarsus) is a rare condition that develops from early closure of the growth plate. 

Epidemiology

Females are almost exclusively affected ¹. 

Pathology

Location

It typically involves the fourth ray or, less frequently, more than one metatarsal bone. Supernumerous sesamoids at the metatarsophalangeal joints are most common in the fifth ray and least common in the fourth ray. The incidence in the first interphalangeal joint is 2% ².

Associations

Brachymetatarsia can be related to several genetic conditions and syndromes:

• aneuploidic anomalies
  • trisomy 21
  • monosomy X / Turner syndrome
• non-aneuoploidic anomalies
  • pseudohypoparathyroidism
  • pseudopseudohypoparathyroidism
  • Albright hereditary osteodystrophy
  • diastrophic dysplasia

Treatment and prognosis

There are several types of lengthening procedures which can be performed. 

For metatarsals that only need to be lengthened up to 15 mm, single-stage lengthening procedures with a variety of biologic and synthetic implants are preferred, whereas gradual lengthening allows for greater length gain and concomitant lengthening of the soft tissues.