There’s an old Sesame Street song that goes “One of these things is not like the others.” Kids are asked to look for differences and pick out the thing that doesn’t belong—like a shoe grouped with an apple, banana and orange. We train our eyes to notice differences, so when one toe is shorter than the others and is lifted up, it’s not something you will glance over and ignore—at least not at first.
The medical term is brachymetatarsia—brachy for short, and metatarsia referring to your foot bones, because the short bone is actually not in your toe but in your foot. X-rays plainly show if you have this condition, and our exam can help us decide whether a short toe needs treatment or not.
If the deformity is not painful or doesn’t limit what you do, you are probably fine just finding shoes that fit well over the toe without rubbing or pressuring it. This is important to reduce the chance of a blister, corn, or callus on the toe that could form with friction from footwear.
However, the shorter toe will not handle its share of body weight properly, and this can lead to poor biomechanics, which in turn aggravate other foot issues. That’s why we often treat the condition with a surgical procedure to lengthen the toe.
One method, called acute lengthening, is to cut the affected bone and insert a bone graft to immediately make it longer. With another method, a cut is made in the short metatarsal and pins are put into each section. These are attached to a device that allows us to slowly increase the distance between them. As the bone is distended, it fills in the gap with new bone tissue and becomes longer. This is called gradual lengthening. Sometimes a combination of the two procedures is used.
You don’t have to deal with a shortened toe that is causing pain or other issues in your feet. Contact Southern California Foot & Ankle Specialists today and schedule a time for us to examine your problem toe(s). We’ll help you decide what treatment will be best for your situation. We’ll discuss everything with you thoroughly so you can prepare for surgery if it is necessary and plan for your recovery time. You can use our contact form to schedule or give our Ladera Ranch office a call at (949) 364-9255 (WALK) for more information on how we can help you!