Brachymetatarsia is an abnormally short metatarsal that presents as a short,
overriding, floating toe. This condition is the result of a stoppage of the
growth plate of the affected metatarsal. Most individuals first notice the
affect on the toe at or around age 7 years old. As the body continues to grow
the toe does not. The cause of brachymetatarsia is unknown in many cases and is
thought to be genetically related in most cases, but can be associated with
previous trauma to an immature or young foot. Other conditions such as
pseudohypoparathyroidism, Down's syndrome, Albright's hereditary osteodystrophy
have been associated. This condition more commonly affects the fourth
metatarsal, but it can affect multiple metatarsals. Brachymetatarsia may
present on one foot, but often affects both feet. Brachymetatarsia is more
common in females with ratio of females to males of 25:1
The signs and symptoms vary with the degree of severity, age and activity of
the person. Although one may not experience any pain or discomfort to the foot,
many have tenderness, soreness, calluses or pain to the bottom of the foot in
the areas of the foot surrounding the short bone. (photo of bottom of the foot).
Another area of discomfort is the rubbing of the floating short toe which makes
wearing certain dress shoes or high heels unbearable.
Of particular interest is the emotional impact on persons afflicted with
brachymetatarsia. After seeing hundreds of patients with the condition, I have
yet to see a person who has not been negatively affected by the nature of this
pathology. Many have lived all their lives hiding their feet from the public
eye. No Pools, beaches, flip flops, sandals, or bare feet.
Once the foot bone have matured and the growth plates "closed" no more length
of the bones can be expected. This usually occurs at age 16 years old.
This is the earliest that one should attempt any type of surgical correction.