When we think of limb lengthening, we often think of bones like the femur or tibia.

It is however possible to lengthen many bones in the body.

Brachymetatarsia is a condition where one of the ‘ray bones’ or metatarsals in the foot fail to grow out fully. This leads to a short metatarsal which is known as ‘brachymetatarsia’. This often happens in the fourth ray, meaning that the fourth toe looks as short (or even shorter) as the little toe.

This condition obviously has cosmetic effects, but can also lead to a painful condition called metatarsalgia (forefoot pain).

An elegant way to solve this problem is by gradually lengthening the metatarsal bone with a small little external fixator as seen in this picture:

The bone is fixed with a mini-fixator prior to being cut in a very specific way.

Slow distraction of the bone at around .5mm per day proceeds until the toe is lengthened to its new length.

The fixator then stays on until the bone is nice and strong and healed.

Total time in the fixator is around 12-16 weeks.

After removal of the external fixator the appearance of the foot is usually better and shoewear is also improved.

These are delicate procedures and are best done by surgeons that have good experience with the technique, but also with limb lengthening in general.

#evensmallbonesmatter