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Short Toe Surgery

Short Toe Surgery in London

If surgery is advised to lengthen your metatarsal (and realign toe position), your specialist will initially carry out an X-ray to assess which surgery is most appropriate for you.

This is a relatively common operation where extra length is achieved by inserting additional bone. This process of inserting additional bone is also known as a bone graft. The new bone need only be small, typically up to 1.5cm, the bone can be taken from another part of the body, such as the heel bone. Once the bone is inserted, the area is stabilised with a bone plate and screws that remain in the foot indefinitely. There is a limit to the additional length that can be achieved with this procedure. As a result this surgery is generally recommended when less than 1.5cm lengthening is required and only for one toe. You will need to take the first 4 – 6 weeks off from work following surgery. You may require a cast for the first 4 – 6 weeks, following this you may be transferred into an aircast boot for a further 2 – 4 weeks. Full bone healing takes up to three months. Swelling subsides over 6 – 12 months for the final result to be appreciated.
This procedure allows for a greater increase in bone length. The operation involves a precise cut to the bone that does not impede the blood supply followed by attachment of an external fixator device that will stretch the short bone over time. The external device allows you to slowly increase the bone length a little each day, after which the device is removed. The bone will gradually increase 1mm per day until the desired length is achieved. Once the bone has healed the fixation will be removed between 1 – 2 months postoperatively. Full bone healing takes up to 3 months. You will be in a specialised cast or boot for a period of up to 3 months. Larger deformities in bone length can be corrected using this technique.

Frequently Asked Questions

Brachymetatarsia is a short metatarsal affecting the feet. It can involve one or more metatarsals, most commonly the fourth metatarsal, resulting in a short or elevated fourth toe. It appears to affect women more frequently than men.

The cause of brachymetatarsia is poorly understood. It occurs when metatarsal growth becomes stunted. It is often seen in family members, suggesting a possible genetic link, though injury has also been suggested as a contributing factor.

Brachymetatarsia can only be corrected through surgical lengthening procedures of the metatarsal using various available techniques.

Patients often experience shoe irritation and discomfort. Many feel embarrassed by the appearance of the toe, leading to psychological distress and avoidance of exposing their feet in public. The impact can be both physical and emotional.

Non-surgical treatment includes wearing deep and roomy shoes. Surgical options include single-stage lengthening using bone grafts and fixation plates, or gradual lengthening using an external fixator over several weeks until healing is confirmed.

It is not possible to fix brachymetatarsia or lengthen the bone without surgery.

Recovery depends on the procedure. Single-stage lengthening typically involves 5–6 weeks in a cast followed by a walking boot, with return to trainers around 10 weeks. Swelling can persist for up to a year. External fixation requires longer immobilisation and complete healing may also take up to one year.

Walking is not allowed for the first six weeks after surgery. After this period, gradual weight bearing may begin in a protective boot.

There is ongoing debate. It may result from abnormal skeletal growth or genetic predisposition.

Package prices range between £7,000 and £10,000 per foot. Only one foot can be operated on at a time due to postoperative immobilisation requirements.

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