Brachymetatarsia
Specialist

Brachymetatarsia FAQ

What method does Dr. Khosroabadi prefer to use for this condition?

Dr. Khosroabadi prefers lengthening the bone because this is the most stable treatment and has the fewest complications. Once the bone heals, it will be as strong as before and most patients can resume their full activities. Once completely healed, the bone can last a lifetime.

How long does the surgery take?

Every procedure is slightly different, but usually a Brachymetatarsia surgery will take between 1 to 3 hours.

When will I get instructions on adjusting the external fixation?

Usually after 5 to 7 days, Dr. Khosroabadi will see you in his office and give you instructions on how to adjust the external fixation at home.

Once I start lengthening the bone with external fixation, how long does it take before I finish the lengthening?

This really depends on how much lengthening your toe needs, every case is different. We usually lengthen the bone about .5 mm a day, but that can very from one patient to another. For example, if your toe were 2 centimeters short, then the lengthening would take about 40 days.

Do I always turn the external fixation the same amount during lengthening phase?

No, this can be changed based on x-ray findings. Dr. Khosroabadi will see you in his office every two weeks to take x-rays. If you're out-of-state, then you will need to go to a doctor who will take and send the x-rays to Dr. Khosroabadi every two weeks. Based on the findings in the x-ray, Dr. Khosroabadi might change the rate from one turn a day to two turns a day or maybe even one turn every other day.

Why does Dr. Khosroabadi change the rate of turning the external fixation?

During the lengthening phase, the rate of generating new bone can change based on your weight-bearing, health and nutrition status. Based on x-ray findings, if you're not growing enough new bone, Dr. Khosroabadi will slow down the rate of turning so the new bone can develop. If Dr. Khosroabadi finds the bone is getting solid at a faster rate, he might speed up the lengthening.

How long after I stop turning the external fixation can we remove the device?

Because we are generating new bone this can vary, but the removal date of the external fixation is anywhere between 8 -16 weeks.

Is it possible that I can get an infection?

Almost every patient develops a superficial infection, which feels tender and red around the pins of external fixation. But everyone is different, so you may not get any infection. However, if you do develop a superficial infection, Dr. Khosroabadi will give you antibiotics that will quickly resolve the infection.

Is the infection around the pin dangerous?

Not as long as you report to Dr. Khosroabadi as soon as you see or feel the infection and are placed on antibiotics.

Are there any other complications?

A list of the most common complications with any kind of surgery will be given to you at time of consent. However, Dr. Khosroabadi will make sure you are treated for any complications that may arise. That said, this is a low risk surgery.

Can I put my complete weight on my foot?

The answer to this question also varies from one patient to another. In general at the beginning, you're able to put full weight on your foot. As you start lengthening the bone, the ability to put weight on it becomes less. During the lengthening process the new bone is much weaker, so you're not able to put as much weight on it. Once we stop lengthening the bone, within couple weeks, you’ll be able to put more and more weight on it.

Are there going to be big scars?

After your surgery, the incisions will heal completely. Usually within one year, the scar is very minimal. Keep in mind that everyone is different so some patients may scar more than the others. Please let us know if you are keloid, as this condition will leave a very bad scar with any type of surgery.

How long before I can wear high heels or participate in sports activities?

Usually about 10 weeks after surgery, you should be completely healed, depending on how well your new bone develops. Dr. Khosroabadi will let you know when you can wear high heels or be involved in sports activities.

As Dr. Khosroabadi doing the surgery himself?

Yes, absolutely, this surgery is very complicated and needs an experienced hand. Dr. Khosroabadi is one of the most experienced surgeons in lengthening toes.

I have more than one toe that needs to be lengthened on each foot can the same surgery be performed?

Even though it is not that common, Dr. Khosroabadi has operated on feet that have had up to three toes affected by this condition.

I have seen advertisements of a different doctor doing implants (silicon) and getting toe lengthening results immediately. Is that a good treatment?

That is the worse surgery I have ever seen being advertised for this condition. That procedure is very temporary and whoever came up with that procedure has no idea about surgical fundamentals. The surgeon puts a silicon implant in the joint to try to achieve a cosmetically acceptable result. What they don’t explain is how the toe joint will function later. I cannot possibly imagine how you can fix the joint and the silicone implant is expected to work long-term. In my opinion the implant will dislodge and destroy that joint sooner or later.

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