Jennifer Garner usually wears shoes or boots, and when photographers snapped her wearing open sandals, fans realized why: she has a pinky toe that is shorter than the others and in an odd position. This is a relatively rare condition called brachymetatarsia that usually affects the fourth toes, but can happen in any toe. If you have a short fourth toe and it is causing discomfort, we want you to realize that there is treatment that may help you.


Why Your Toe Is Shorter


It is not your toe bones that are shorter, but rather the foot bone (metatarsal) that is attached to them. For some reason, the bone does not grow normally. This could be due to genetic factors such as Albright’s syndrome, Down’s syndrome, or changes in the parathyroid hormone level.


However, it can also be caused by trauma to the metatarsal that leads to an early closing of the growth plate during foot development. If you are a woman, you are about 25 times more likely to have this condition.


What Brachymetatarsia Looks Like


It usually affects the fourth toes, which appear shorter than the others and lift up above them. Sometimes it may look as if the third and fifth toes have migrated beneath it and are touching each other. If it happens in your pinky toe—as it did for Jennifer Garner—all the other toes may lie flat but the little one lifts up and over the fourth toe. The deformity is very easy to diagnose and X-rays clearly show that the shortened metatarsal is the problem.


4th-brachymetatarsia1-pre op pic

Why You Might Want to Have Your Short Toe Lengthened

It is possible that you have no unpleasant symptoms from the abnormality. In that case you may not need treatment, other than to modify your shoe choices to fit the toe.

Although psychological factors may be involved (wanting the toe to look more “normal”), the most prominent reason to have the toe corrected is pain. The toe position can interfere with wearing shoes, and pressure or irritation from contact with the front of the shoe can cause discomfort.

Because the toe does not lie straight, it doesn’t do its share of supporting your foot. The load it would normally bear is transferred to adjacent toes, causing undue pressure and pain. Also, it messes with the alignment in your forefoot and can cause faulty biomechanics that can lead to other forefoot problems.

How We Can Correct Brachymetatarsia

Brachymetatarsia-after-gradual-callus-distraction-with-an-Ex-fixUnfortunately, conservative treatments may not work for a short fourth toe that is causing extreme discomfort. There are three types of surgery, however, that work well.

  • Acute lengthening is done with a bone graft that is inserted to increase the metatarsal length.
  • Gradual lengthening involves cutting the bone and using an external fixator to gradually lengthen it as new bone growth fills in the space.
  • The third option is a combination of the first two.

We will discuss the procedures and decide which is a better fit for your particular situation. We’ll also let you know what to expect for recovery times so you know how to plan.

Southern Orange County Experts in Foot Surgery

The doctors of Southern California Foot & Ankle Specialists are highly trained and experienced surgeons. If you want to discuss corrective surgery for a short toe, contact our office in Ladera Ranch, CA by calling (949) 364-9255 (WALK) or requesting an appointment online. You have options, and we would be honored to provide the expert foot care you need.

Contact Us

Robert Spencer, DPM

Nitza Rodriguez, DPM

Mario Porciello, DPM

Map & Directions

333 Corporate Drive, Suite 230, Ladera Ranch, CA 92694
Tel: (949) 364-9255 (WALK)
Fax: (949) 364-9250
Office Hours:
Monday - Friday: 9am - 5pm
*(Lunch 12 noon - 1pm)