Have you ever wondered why some feet you see seem to have one very short toe as compared to all the other toes? This is an actual medical condition and is called brachymetatarsia (congenital short toe). This occurs when either the toe bones or, more commonly, the long bone in the foot fails to reach a mature length equal to the others. It has a strong genetic component and can be seen in one or both feet.
The condition may be evident from birth but usually becomes more noticeable when the feet begin to grow. Early on the condition may not affect walking, but as the foot begins to grown and the length of the toe falls behind the other toes on either side of it, structural changes to the foot may begin show.
One common additional finding in our experience with this condition is the presence of a bunion. The foot is very sensitive to structural changes and when the buttress(support) effect of one toe stabilizing the next toe is lost, then all toes may begin to deviate toward the gap that occurs because of the short toe. This then may lead to a bunion. In addition to a bunion, callouses or pain may develop in the foot on either side of the short toe.
Unfortunately, this condition can only be corrected surgically, though many people choose to live with it if their pain is not severe. Correction involves lengthening the long bone of the short toe by making a cut in the centre, inserting some pins in the two halves, applying a distractor(stretching device) and slowly stretching the bone over a period of 3-4 weeks time. Length is achieved at a very slow rate, usually 1mm a day. Once the desired length is achieved the device is removed and the bone is left to "harden". Once the bone becomes solidified (confirmed by Xrays), the patient may return to normal activity with a foot that now has a more aesthetically pleasing appearance and an improved structure for bearing weight.