 | Robert Scheibmeir
is owner and operator of Foot Care of Kansas, and the Good Feet Store. The Good Feet Store is a dealership that was opened in October 2001. Foot Care of Kansas opened in June 2002 and serves the needs of diabetics as well as other medical foot care problems. Prior to purchasing Foot Care of Kansas and the Good Feet Store, Mr. Scheibmeir owned and operated Robert’s Shoecare Services in Hutchinson, Kansas for 12 years. Robert has been working with foot care for more than 23 years. He became a Certified Pedorthist in 1999, which requires an extensive knowledge of the foot and how to make shoes and arch supports work together. You may contact Robert at Good Feet at 316-945-9300 or at Foot Care of Kansas at (316) 944-2120. |
Health & Medicine
2002-11-01 16:36:00
What is brachymetatarsia?
: What is a condition called Brachymetatarsia? Other than wait until one gets older, how does one know he or she has it?
ANSWER: Brachymetatarsia is a condition in which one of the metatarsals (the five long bones of the foot) is abnormally short, resulting in a short toe. This condition commonly occurs bilaterally, in the fourth toe. If more than one toe is short, the condition is called brachymetapody. In most cases, brachymetatarsia is caused by the growth plate of the metatarsal closing too early. Once the growth plate closes, the bone can no longer grow. This may be caused by a genetic factor or by trauma to the foot. Typically, a fracture of one of the metatarsals goes through the growth plate, preventing further growth. A shortened metatarsal can cause several problems. Normally, in walking, the weight is transferred from the fifth toe to the fourth, then to the third, and so on until it reaches the first (hallux). This is because the toes are gradually longer and as weight is transferred to the forefoot, the next longest toe takes over. Brachymetatarsia disrupts this process. Biomechanically, it is like having no toe at all. If the fourth toe is shorter than the fifth, it never receives the weight of the body and cannot transfer it appropriately to the third. As a result, the fifth and third toes receive extra weight, causing pain in those areas. An unnaturally short toe also tends to drift upward, causing problems wearing shoes. Treatment options for brachymetatarsia are limited. Conservative treatment involves wearing shoes with extra depth to allow the shortened toe more room. Padding can keep the toe from ulcerating due to pressure and friction against the top of the shoe. Orthotics can help ease the pressure under the other toes. Another treatment option is surgery to lengthen the short toe. This usually is accomplished by cutting the short metatarsal and grafting a piece of bone between the two ends. When the graft heals, the metatarsal and toe are the correct size. Some lengthening of the toe's extensor tendons and surrounding skin usually is necessary to accommodate the repaired toe. An exceptionally short metatarsal may make grafting impossible. In this case, the two metatarsals flanking it may be shortened slightly to correct the arc of the toes. The two shortened toes are then proportionate to the original short toe, restoring the foot's ability to transfer weight sequentially. Follow up treatment typically involves keeping all weight off the surgically repaired foot for 3 months, after which the patient wears a snug-fitting lace-up shoe (an oxford or a jogging shoe) for about 6 weeks. A new technique uses an external device that is attached to the metatarsal with pins. The bone may be gradually drawn out to the appropriate length by this method.
