As a Manhattan foot surgeon, one of the most rewarding surgeries I perform are cosmetic toe lengthenings. A short toe often causes tremendous psychological embarrassment for people, and fixing this makes a dramatic change in someones life.
What is it: A majority of people with short toes have a condition called brachymetatarsia. It is the result of a growth disturbance of a toe bone called a metatarsal. The affected bone ceases to grow while the surrounding bones grow at a normal pace -- resulting in a short toe.
The symptoms: Most commonly, brachymetatarsia involves the fourth toe, and some patients could have multiple short toes on one foot or on both feet. It can occur in the hands as well. In addition to being short, the toe sits higher up on the foot and become irritated by shoes. Surrounding toes may curl under the short toe. Pain is common as the weight distribution is altered and pressure calluses may develop on the bottom of the foot. More than anything, patients tend to be extremely embarrassed of the short toe and results in patients hiding their feet.
How we fix it: The basis for the surgery is to add length to the short bone. One method is to add a bone graft to the short bone, allowing for lengthening in one stage. Another popular method is to grow the bone by gradually stretching it over the course of a few weeks. This is accomplished with a bone stretching device called an external fixator. The images below illustrate the new bone growth and a toe that is proper length.
Nonetheless, the results can be dramatic, and patients have gone from hiding their feet to showing them off.
-- Dr. Neal Blitz
New York City
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