• Journal of Korean Foot and Ankle Society
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• v.3 no.1
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• pp.33-39
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• 1999

Brachymetatarsia of the first metatarsal is uncommon. It may occur as a congenital condition. Hallux varus is the name given to a medially deviated position of the first metatarsophalangeal joint with a nonpurchasing hallux in varus position. To have a patient with not only both hallux varus and brachymetatarsia, but for the brachymetatarsia to occur about the first metatarsal, is extremly rare. We experienced a case of the brachymetatarsia of the first metatarsal with hallux varus treated by callotasis. Excellent cosmetical and funtional outcome were obtained. So we reporting the case with a review of the literatures.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.42-46
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• 2005

Purpose: To evaluate the efficacy of distraction osteogenesis for fourth brachymetatarsia. Materials and Methods: Seven patients (10 cases) who were treated by distraction osteogenesis for fourth brachymetatarsia from March 2000 to December 2003 were reviewed retrospectively. Results: The average length gain of fourth metatarsus was 16.6 mm (37%) and the average healing index was 50 days/cm. The final results according to AOFAS functional scale were excellent in 8 cases and good in 2 cases. Conclusion: Distraction osteogenesis is an effective treatment for fourth brachymetatarsia in spite of some minor complications.

• Journal of Korean Foot and Ankle Society
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• v.16 no.3
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• pp.197-201
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• 2012

Callotasis has been widely used to treat brachymetatarsia. But various complications have been reported. Avascular necrosis of the $4^{th}$ brachymetatarsia treated by callotasis has not been frequently addressed in the literature. We report 1 cases of avascular necrosis of the $4^{th}$ brachymetatarsia treated by callotasis with a review of the literature.

• Journal of Korean Foot and Ankle Society
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• v.16 no.3
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• pp.156-161
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• 2012

Brachymetatarsia is a rare congenital deformity which occurs most commonly in the fourth metatarsal. Most common purpose of surgery is to make a normal metatarsal parabola for better external appearance as well as physiological load bearing under the metatarsal heads. Common surgical treatment for brachymetatarsia is lengthening of short metatarsal either by one-stage lengthening with intercalary bone graft or gradual lengthening by distraction osteogenesis. Sometimes shortening of long metatarsal is combined with lengthening of the short metatarsal. The function of the foot is diminished due to diverse complication accompanying lengthening of the metatarsal, therefore preoperative consultation about the functional result is essential.

• Journal of Korean Foot and Ankle Society
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• v.9 no.2
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• pp.140-145
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• 2005

Purpose: To analyze the outcome of metatarsal lengthening of first brachymetatarsia by callotasis using an external fixator. Materials and Methods: Between January 1998 and February 2004, 10 patients (17 cases) were reviewed. The mean age at operation was 17.3 years. Seven patients had bilateral first brachymetatarsia and eight patients had combined 4th brachymetatarsia. The operations were performed with a monoexternal fixator, and distraction was started at a rate of 0.75 mm/day after 7 days. The radiographic results were evaluated by lengthening amount and percentage, fixation time, and healing index. Complications and AOFAS score were evaluated. Results: The average lengthening amount was 17.7 mm and the average lengthening percentage was 43.4%. The external fixation time was 107 days and average healing index was 69.8 days/cm. The evaluation according to AOFAS score was excellent in 12 cases and good in 5 cases. Complications were 4 cases of hallux valgus, 4 of metatarsophalangeal joint stiffness, 3 of medial angular deformity, 3 of pes cavus, 2 of pin breakage, 2 of pin site infection, and 1 of skin hyperpigmentation. Conclusion: Callotasis for 1st brachymetatarsia is a very useful treatment method with high patient satisfaction, excellent healing rate and early ambulation without bone graft. Nevertheless, great care must be taken to minimize the various possible complications.

• Journal of Korean Foot and Ankle Society
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• v.13 no.2
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• pp.218-222
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• 2009

In general, the operative treatment of the brachymetatarsia is the lengthening of the affected metatarsal bone due to the cosmetic problem rather than the functional one. We experienced 22 year-old female bilateral congenital foot deformities such as hallux varus and 1,4th brachymetatarsia treated with reverse Scarf osteotomy on the hallux varus and massive axial metatarsal shortening Weil osteotomy on the 2,3,5th metatarsals which could reconstruct the normal metatarsal parabola.

• Journal of Korean Foot and Ankle Society
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• v.6 no.1
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• pp.73-79
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• 2002

Purpose: To evaluate the effectiveness of callotasis using the external fixator for the treatment of brachymetatarsia. Materials and Methods: Eleven patients(15 cases) who underwent callotasis were available. Follow-up averaged 23 months(15-38 months). Both the patients' postoperative satisfaction and the postoperative radiographic results were retrospectively evaluated. Results: The duration from applying the external fixator to remove averaged 15 weeks (8-21 weeks). We did osteotomy again in two cases because of early consolidation at the osteotomy site during distraction period. All cases were evaluated mild claw toe deformity and motional pain in metatarsophalangeal joint, but all patients satisfied the postoperative results except one complained motional pain and stiffness in metatarsophalangeal joint. The metatarsal shortening averaged 13mm(9-18mm) before operation. The amount of distraction for shortened metatarsals averaged 15mm(5-22mm). We found the 6 cases of narrowing of the metatarsophalangeal joint, 2 cases of subluxation of the metatarsophalangeal joint. Conclusion: We think that callotasis with external fixator is good operative method for the brachymetatarsia.

• Journal of Korean Foot and Ankle Society
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• v.10 no.1
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• pp.24-30
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• 2006

Purpose: To present our treatment protocol and surgical outcome for patients with congenital brachymetatarsia in which treatment was decided according to the number of affected rays. Materials and Methods: Sixty-nine metatarsals in 44 patients with single or multiple congenital brachymetatarsia were included in the study. When a single ray was affected in a foot, we performed a one-stage lengthening using an intercalary autogenous iliac bone graft. We overcame excessively short rays by the double level lengthening at the metatarsal and proximal phalanx as one stage. When multiple rays were affected in one foot, we performed a one-stage combined shortening and lengthening procedure without an iliac bone graft. Results: All patients were satisfied with the cosmetic and functional results. The average length gain by one-stage lengthening in 56 metatarsals of 38 patients was 14 (6-21) mm. Six patients with a combined shortening and lengthening procedure regained a nearly normal parabola of the involved foot. Neurovascular complication was not identified. Conclusion: Satisfactory results were achieved for the treatment of patients with congenital brachymetatarsia, by individualizing the surgical options according to the number of affected rays and general foot appearance.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.182-185
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• 2010

19 years old girl presented with bilateral 1, 4th brachymetatarsia. We have used an autograft interposition technique to lengthen the brachymetatarsia involving first and fourth metatarsal. The technique was to graft the bone fragment from the relatively long second and third metatarsal bone to be used as an autograft to the short first and fourth metatarsal bone. The method is superior in not having the necessity of a long term external fixator which is needed using callotasis method and in also avoiding the inconvenience of performing an allograft. Absence of donor site complication during autograft from iliac bone is also an advantage to be mentioned. Our technique can therefore be ascertained as a successful method in both cosmetic results and improvement of symptoms including reduction in length of recovery.

• Journal of Korean Foot and Ankle Society
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• v.14 no.2
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• pp.186-189
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• 2010

Among congenital brachymetatarsias fourth metatarsal bone shortening is most common form and unusually involves multiple metatarsal bones. We report a case of the patient with bilateral 1st and 4th multiple rays brachymetatarsia treated with callostasis. Twenty eight months after procedure, right side showed 1st metatarsal lengthening about 11.5 mm (29.23%) and 4th metatarsal 17.86 mm (35.87%). Twenty one months later, left side showed 1st metatarsal lengthening about 14.58 mm (36.8%) and 4th metatarsal 20.52 mm (43.01%). In healing index right side showed 1st metatarsal 3.4 month/cm, 4th metatarsal 2.5 month/cm and left side showed 1st metatarsal 4.2 month/cm, 4th metatarsal 2.3 month/cm. Final follow-up results presented excellent outcome in cosmetic problem, easy wear of shoes, and measurement of patient's self satisfaction.