Treatment options for brachymetatarsia

Brachymetatarsia can be congenital, idiopathic or secondary and describes an abnormal shortening of a metatarsal bone. The indications for treatment are not only due to cosmesis. The shortening of a ray changes the biomechanics of the foot and can lead to metatarsalgia. A frequent clinical feature i...

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Bibliographic Details
Published in:Der Orthopäde 2013-01, Vol.42 (1), p.30
Main Authors: Wingenfeld, C, Arbab, D, Abbara-Czardybon, M
Format: Article
Language:ger
Subjects:
Child
Child, Preschool
Foot Deformities - diagnostic imaging
Foot Deformities - surgery
Humans
Infant
Male
Metatarsal Bones - abnormalities
Metatarsal Bones - diagnostic imaging
Metatarsal Bones - surgery
Osteogenesis, Distraction - instrumentation
Osteogenesis, Distraction - methods
Osteotomy - instrumentation
Osteotomy - methods
Radiography
Reconstructive Surgical Procedures - methods
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Summary:Brachymetatarsia can be congenital, idiopathic or secondary and describes an abnormal shortening of a metatarsal bone. The indications for treatment are not only due to cosmesis. The shortening of a ray changes the biomechanics of the foot and can lead to metatarsalgia. A frequent clinical feature is dorsal dislocation of a toe causing painful shoe conflict and disturbed proprioception. There are three main options for operative correction: lengthening osteotomy, interposition of a tricortical bone and gradual lengthening by callus distraction. While one stage lengthening procedures such as osteotomy and interposition are more appropriate for correction of moderate length deficiencies, the callus distraction method is more suitable for larger elongation. Common to all procedures is a long-term treatment with a high risk of different complications whereby patient compliance can be problematical.
ISSN:1433-0431
DOI:10.1007/s00132-012-1987-7