Two cases of complete polymetatarsia without polydactyly

Area of Science:

• Orthopedics
• Medical Imaging
• Surgical Case Reports

Background:

• Polymetatarsia, a rare foot anomaly involving duplication of metatarsal bones, is infrequently reported, especially in its complete form without supernumerary digits.
• Existing literature primarily describes incomplete duplications, making complete polymetatarsia without polydactyly a significant diagnostic and clinical challenge.

Observation:

• Two patients presented with radiographic evidence of an extra bone between the fourth and fifth metatarsals of the right foot, despite lacking external deformities.
• Plain radiographs were crucial in identifying the anomalous bone, differentiating it from conditions like os intermetatarseum.

Findings:

• Complete polymetatarsia was diagnosed based on the extra metatarsal's configuration (articular cartilage, growth plate), its location, and the presence of polydactyly in the contralateral foot.
• Resection of the extra metatarsal in one symptomatic patient resulted in complete pain relief, confirming its pathological nature.

Implications:

• These cases expand the understanding of polymetatarsia variations, highlighting the importance of radiographic evaluation for subtle bone anomalies.
• The findings underscore the need for careful differential diagnosis and suggest that surgical resection can be an effective treatment for symptomatic complete polymetatarsia.