Surgical treatment of congenital brachymetatarsia

Abstract

Introduction: Congenital brachymetatarsia is a relatively rare condition that concerns metatarsal bone shortening. The aim of this retrospective study was to assess the surgical outcome of various forms of congenital brachymetatarsia treated by using our protocol. Patients & methods: A total of 69 metatarsals in 44 patients with single or multiple congenital brachymetatarsia were included in the study. When a single ray was affected in a foot, we performed a one-stage lengthening using an intercalary autogenous iliac bone graft. When multiple rays were affected in one foot, we performed a one-stage combined shortening and lengthening procedure without an iliac bone graft. If intraoperative distraction of the metatarsal could not achieve satisfactory toe-tip parabola, concomitant proximal phalangeal lengthening was performed. The mean follow up was 3.5 (1.5–9) years. Results: All patients were satisfied with the cosmetic and functional results. The average length gain by one-stage lengthening in 56 metatarsals was 14 (6–21) mm. Six patients with a combined shortening procedure regained a nearly normal parabola of the involved foot. No case was complicated by subsequent neurovascular impairment. Conclusion: Our experience suggests that satisfactory results can be achieved for the treatment of patients with congenital brachymetatarsia, if surgical options are carefully individualized concerning the patient’s expectation and general foot appearance.