Operative Treatment for Brachymetatarsia

Abstract

Purpose : To evaluate the importance of various surgical techniques in the treatment of brachymetatarsia. Materials and Methods : The study involved 33 cases, categorized as follows: group A: treated by one-stage lengthening (4) or callotasis (9) without bone shortening; group B: treated either by one-stage lengthening (3) or callotasis (15) with bone shortening or bone shortening only (2). Fifteen patients were reviewed in terms of the length gain (LG), healing index (HI), percentage increase (PI), and complications. Results : The results in both group A [one-stage lengthening (mean: LG 1.4 cm, HI 1.2 months/cm, PI 0.3) and callotasis distraction (LG 1.8 cm, HI 2.2 months/cm, PI 0.4)] and group B [one-stage lengthening (LG 1.3 cm, HI 1.3 months/cm, PI 0.3) and callotasis (LG 1.8 cm, HI 2.1 months/cm, PI 0.5)] were satisfactory. The averaged amount of bone shortening at 23 levels was 0.8 cm. It magnified the cosmetic effect and consequently reduced on average 1.8 months after treatment period in the callotasis group. Conclusion : In managing brachymetatarsia, bone shortening of the neighboring metatarsal and phalanx, a form of epiphysiodesis, and surrounding soft tissue release reduce the treatment period and the associated complications.