Novel surgical correction of brachymetatarsia using 3D printed custom implant

Brachymetatarsia is a condition of congenital shortening of the metatarsal. Surgical intervention traditionally consists of lengthening procedures of the metatarsal utilizing techniques such as distraction osteogenesis and bone allograft/autograft implantation. These procedures can lead to a variety of complications including stiffness, malalignment, resorption of bone, and delayed consolidation. Intervention consisting of a custom 3D printed implant can maintain metatarsal length following an osteotomy without risk of bone graft resorption. To our knowledge, we are presenting the first case of using a 3D printed custom implant used to restore metatarsal length. The patient is a 56-year-old female with painful brachymetatarsia involving the fourth metatarsal of her left foot and complaining of 8/10 pain. The patient’s fourth metatarsal was 11.8 mm shorter than the fifth metatarsal. The patient underwent fourth metatarsal osteotomy with distraction and insertion of 3D printed custom implant. The length of the patient’s fourth metatarsal was successfully maintained with insertion of the implant and stabilization with a plate and screws. At 36 months post-operatively, there was no evidence of resorption, malalignment, or delayed consolidation.