Lamm Bradley M, Lamm Tyler B
Chief, 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.
Student, Oxbridge Academy, West Palm Beach, FL.
J Foot Ankle Surg. 2023 Jan-Feb;62(1):132-149. doi: 10.1053/j.jfas.2022.06.002. Epub 2022 Jun 11.
Brachymetatarsia is a congenital osseous and soft tissue deformity of a ray(s) of the foot. Because there is no particular consensus of methodology of lengthening for brachymetatarsia, the authors introduce a comprehensive anatomic classification and a surgical guide to treatment of each classification type. This classification combines the number of the metatarsal(s) affected and the letter(s) indicating the type of brachymetatarsia deformity (A = axial deficiency of the metatarsal, B = bowing of the metatarsal, C = congruency of metatarsal phalangeal joint). This study reviewed of 300 brachymetatarsals in 166 patients. Fifty of the 166 (30%) patients had bilateral brachymetatarsia. Of the 300 metatarsals with brachymetatarsia, 64 (21%) were first metatarsals, 22 (7%) were second metatarsals, 28 (9%) were third metatarsals, 12 (4%) were fifth metatarsals, and 174 (58%) were fourth metatarsals. Classification types that were found was a total of 165 (55%) type A, a total of 6 (2%) type B, a total of 72 (24%) type AB, a total of 39 (13%) type AC, and a total of 18 (6%) type ABC. A total of 16 (10%) male and 150 (90%) female patients were evaluated. The mean preoperative amount of shortening of the metatarsal was 15 mm (range, 4-20 mm), as determined by the preoperative metatarsal parabola deficiency, equating to 30% of the preoperative metatarsal length. Brachymetatarsia is a complex congenital deformity which until now has not been critically analyzed. This study outlines a comprehensive brachymetatarsia classification system which provides an accurate diagnosis of the deformity and offers a surgical treatment algorithm.
短跖骨是足部某一跖骨的先天性骨与软组织畸形。由于短跖骨延长方法尚无特别一致的意见，作者介绍了一种全面的解剖学分类以及针对每种分类类型的手术治疗指南。这种分类结合了受累跖骨的数量以及表示短跖骨畸形类型的字母（A = 跖骨轴向发育不全，B = 跖骨弓形，C = 跖趾关节匹配）。本研究回顾了166例患者的300根短跖骨。166例患者中有50例（3０%）为双侧短跖骨。在300根短跖骨中，6４根（21%）为第一跖骨，22根（7%）为第二跖骨，28根（9%）为第三跖骨，12根（4%）为第五跖骨，174根（58%）为第四跖骨。发现的分类类型共有165例（55%）为A 型，6例（2%）为B型，72例（24%）为AB型，39例（13%）为AC型，18例（6%）为ABC型。共评估了16例（10%）男性和150例（90%）女性患者。根据术前跖骨抛物线缺损确定，跖骨术前平均缩短量为15 mm（范围4～20 mm），相当于术前跖骨长度的30%。短跖骨是一种复杂的先天性畸形，迄今为止尚未进行过严格分析。本研究概述了一种全面的短跖骨分类系统，该系统可对畸形进行准确诊断并提供手术治疗方案。
