[A rare shortening of the first metatarsus of the foot and its treatment with distraction arthrodesis].

Multiple toes may develop on the medial or lateral side of the forefoot or in its middle. This may involve duplication of only the distal phalanx or the whole hallux including the metatarsal. In a duplicated big toe, the phalanx to be maintained, because short muscles of the leg are attached to it, is usually localized medially. A rare case of dysplasia of the first metatarsus, following a resection indicated in childhood for a hallux triples, is described in a 20-year-old girl. In order to remove hallux insufficiency and an overloading of the middle metatarsals, the authors decided to carry out a one-stage prolongation of the first metatarsal, using an autologous tricorticcal graft collected from the pelvis and a dynamic compression plate. No surgical treatment of the middle metatarsals was indicated because a disproportionate, short foot would result. Both the subjective and objective status of the patient at 6 months after the operation showed that the non-standard prolongation procedure was correctly indicated and allowed for physiological loading of the foot and restoration of normal walking.