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orthopaedic surgeons

Case 2: Metatarsal Lengthening

Written by: Dr F Birkholtz

This 14 year old girl presented with a congenital (inborn) shortening of her fourth toe. This is called brachymetatarsia. She requested lengthening surgery because of pain in the foot and for cosmetic reason.

                                        Click on the image to enlarge



The 4th toe is shortened due to the shortening of the metatarsal bone behind the toe itself (brachymetatarsia). This can cause pain and discomfort when walking.


During surgery a small external fixator apparatus is placed on the affected bone. Through a small (5mm) skin incision the bone is divided. Gradual lengthening of the bone is achieved by adjusting the fixator daily, until the metatarsal has reached its correct length.


This picture shows a well-corrected foot directly after removal of the external fixator. Note the correct length differrential between the toes. The patient was happy after surgery and returned to school happy with her ‘new foot’.