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Brachymetatarsia: A Classification for Surgical Treatment.

Bradley M Lamm¹, Tyler B Lamm²

¹Chief, Foot and Ankle Surgery, St. Mary's Medical Center & Palm Beach Children's Hospital, West Palm Beach, FL; Director, Foot and Ankle Deformity Correction Center and Fellowship at Paley Orthopedic and Spine Institute, West Palm Beach, FL.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons

|July 11, 2022

Summary

This study introduces a new classification for brachymetatarsia, a congenital foot deformity. The system aids in diagnosing the condition and guides surgical treatment for better patient outcomes.

Keywords:

brachymetapody congenital distraction external fixation metatarsal lengthening osteogenesis short toe

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Area of Science:

Orthopedics
Podiatry
Congenital Deformities

Background:

Brachymetatarsia is a congenital deformity affecting foot rays.
Current surgical lengthening methods lack a standardized approach.
A comprehensive classification is needed for accurate diagnosis and treatment.

Purpose of the Study:

To introduce a comprehensive anatomic classification for brachymetatarsia.
To develop a surgical guide based on the proposed classification.
To provide a standardized approach for treating brachymetatarsia.

Main Methods:

A retrospective review of 300 brachymetatarsals in 166 patients.
Development of a classification system combining metatarsal number and deformity type (A=axial deficiency, B=bowing, C=joint congruency).
Analysis of metatarsal involvement, deformity types, and patient demographics.

Main Results:

The fourth metatarsal was most commonly affected (58%).
Type A deformities were most prevalent (55%), followed by Type AC (13%) and Type ABC (6%).
Mean preoperative shortening was 15 mm (30% of metatarsal length).

Conclusions:

A novel, comprehensive classification system for brachymetatarsia has been established.
This classification provides accurate diagnosis and a tailored surgical treatment algorithm.
The system aims to standardize the management of this complex congenital foot deformity.