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MEDICINA E CHIRURGIA DELLA CAVIGLIA E DEL PIEDE

A Journal on Physiopathology and Surgery of the Foot


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Chirurgia Del Piede 2008 August;32(2):61-7

Copyright © 2008 EDIZIONI MINERVA MEDICA

language: Italian

Brachymetatarsia of the first metatarsal bone

Parino E. 1, Pisani P. C. 1, Marcarelli M. 2

1 Centro di Chirurgia del Piede “Prof G. Pisani” Clinica “Fornaca di Sessant”, Torino 2 Dipartimento di Scienze Ortopediche Traumatologiche Riabilitative e Plastico Ricostruttive II Università degli Studi di Napoli, Napoli Direttore Prof. V. Riccio


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Brachymetatarsia of the first metatarsal is a rare congenital deformity characterized by abnormal shortening of the first metatarsal ray caused by asymmetry of the longitudinal epiphyseal bracket. This causes an arrest in longitudinal growth, resulting in a flattened, short bone trapezoid or triangular in shape that can induce varus hallux. The condition accounts for 2-14% of congenital hand and foot deformities; it is bilateral in 75% of cases and is more prevalent among males. It is classified as a differentiation defect and is often associated with syndactyly and polydactyly. Various surgical treatment methods are described in the literature; all entail excision of the epiphyseal bracket before skeletal bone growth is completed or during the first year of life in order to promote normal longitudinal bone growth. This article presents three cases of bilateral brachymetatarsia in which the first metatarsal ray was lengthened by means of a Penning mini-distractor; one of the three procedures was performed in a patient who had completed bone growth. This surgical approach permits the planning of surgical treatment of skeletal and soft tissue structures.

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