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Length discrepancy in metatarsals
Published in Benjamin Joseph, Selvadurai Nayagam, Randall Loder, Ian Torode, Paediatric Orthopaedics, 2016
The metatarsal heads of a normal foot outline a parabolic arch. The normal first metatarsal can hold one of three relationships with the second ray7: (a) shorter (40 percent), (b) equal (22 percent) or (c) longer (38 percent) (Figure 46.2). These differences, when present, are in the order of a few millimetres. In contrast, shortening in brachymetatarsia is many millimetres and can be less than half the length of neighbouring metatarsals. The parabolic arch of the normal contralateral foot is a guide to the degree of shortening for the affected side.
The dysmorphic metatarsal parabola in diabetes—clinical examination and management: a narrative review
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2021
AT Thompson, B Zipfel, C Aldous
Dudley J Morton (not to be confused with Thomas G Morton after whom the condition known as Morton’s neuroma in the foot is named) recorded and measured brachymetatarsia, which he termed a ‘short first metatarsal’ (SFM).18 As treatment, Morton suggested the use of a ‘compensating insole’ containing a platform beneath the head of the short first metatarsal, which would extend the length of the hallux.18 This is similar to the construction method employed by South African-trained podiatrists, in which the extension pad (or ‘Morton’s extension’) may not necessarily extend the entire length of the hallux (Figure 8).
Management of acute lesser toe pain
Published in Postgraduate Medicine, 2021
Jessyca Ray, Nicholas A. Andrews, Aseel Dib, Whitt M. Harrelson, Ankit Khurana, Maninder Shah Singh, Ashish Shah
Relatively uncommon in adults, brachymetatarsia is a rare abnormality characterized by an atypical shortened metatarsal, most commonly the fourth digit. Idiopathic early closure of the epiphyseal plate is the most common cause of brachymetatarsia [36,37]. On observation, the shortened digit may be dorsally displaced, creating an abnormal pressure distribution in the forefoot leading to pain and crowding of the digits. A diagnosis of brachymetatarsia is made when one or more metatarsals ends 5 mm or more proximally to the metatarsal parabolic arc.