Background: Brachymetatarsia is a rare congenital or developmental condition that results in a short
metatarsal. The condition most commonly affects the fourth metatarsal of young and adolescent
females. It does not usually produce a functional problem. However, it may produce a significant
cosmetic problem especially in young women. The authors present their experience in gradual
distraction of the fourth metatarsal to tackle this problem in adults.
Methods: That was done using a monolateral frame in 11 feet of female patients with an average age of
23 years. Evaluation depended upon the achievement of the target length, angulation, pain, and
satisfaction of the patient.
Results: There were eight excellent and three good results after an average follow up of 2.6 years. Aside
from nine cases of mild pin-tract infection, complications were few and minor.
Conclusions: We recommend distraction osteogenesis as the treatment of choice for brachymetatarsia of
the fourth toe.