Brachymetatarsia is a rare congenital anomaly characterized by the shortening of one or more metatarsals, which can lead to functional impairment, pain, and aesthetic concerns. This case report describes a 17-year-old female patient with brachymetatarsia affecting the third and fourth metatarsals of the right foot, which was unresponsive to conservative treatment and caused persistent pain while standing. To address this condition, a single-stage surgical approach was performed using an autologous calcaneal bone graft to lengthen the affected metatarsals. Additionally, the second and fifth metatarsals were shortened to restore a physiological metatarsal parabola and resolve chronic metatarsalgia. The procedure resulted in complete correction of the metatarsal parabola, full resolution of metatarsal pain, and satisfactory functional recovery. The use of an autologous calcaneal graft proved to be an effective and reliable surgical option due to its cortico-cancellous composition, high osteogenic potential, and low antigenicity. This case highlights the advantages of autologous bone grafting as a valuable technique in the surgical management of brachymetatarsia.

Background/Objectives: Iatrogenic hallux varus is a rare complication often arising after hallux valgus surgery, characterized by medial deviation of the hallux. This report presents the case of a 58-year-old female with iatrogenic hallux varus complicated by rheumatoid arthritis (RA). The objective is to highlight the challenges and outcomes of surgical treatment in RA patients with complex foot deformities. Methods: The patient presented with severe medial deviation of the hallux and claw positioning of the lesser toes, resulting in pain and functional limitations. Radiological analysis indicated overcorrection of the first intermetatarsal angle and deformity of the lesser toes. Surgical management included arthrodesis of the first metatarsophalangeal (MTP) joint using K-wires and resection arthroplasty of the lesser metatarsals. Results: Postoperative outcomes revealed correct alignment, pain reduction, and restoration of functional capabilities. However, a non-union was observed in the first MTP arthrodesis after 24 months, which remained asymptomatic. Conclusions: This case underscores the importance of careful surgical planning in RA patients to balance joint preservation and deformity correction. Arthrodesis proved effective for stability and pain relief in RA-associated deformities, although long-term follow-up remains critical to address complications. Tailored interventions are necessary to improve the quality of life in RA patients with complex foot deformities.

Background/ Objectives Brachymetatarsia is a rare congenital anomaly characterised by the shortening of one or more metatarsals, which can cause functional problems, pain and aesthetic difficulties. We present the case of a 17-year-old female patient with brachymetatatarsia of the 3rd and 4th radii of the right foot, refractory to conservative treatment and with persistent pain during standing. The aim of this study is to describe an innovative surgical approach using an autologous calcaneal graft for the treatment of this pathology. Methods After evaluating all available surgical options, it was decided to perform an au-tologous calcaneal implant at the base of metatarsals 3 and 4 to increase their length. In addition, radii 2 and 5 were shortened to restore a physiological metatarsal parabola and definitively eliminate metatarsalgia. Results The procedure achieved complete correction of the metatarsal parabola. The patient experienced complete resolution of metatarsal pain and satisfactory functional recovery. The autologous calcaneal graft provided adequate support due to its cortico-cancellous composition, high osteogenic capacity and low antigenicity, making it an optimal choice in foot and ankle surgery. Conclusions Autologous calcaneal grafting has proven to be an effective and safe surgical alternative for the correction of brachymetatarsia. Its use makes it possible not only to increase the length of the affected metatarsals but also to de-finitively resolve metatarsalgia, improving the quality of life of patients with this pathology. This case highlights the usefulness of autologous grafts in reconstructive procedures of the foot, due to their structural and biological advantages.