Idiopathic bilateral brachymetacarpia–brachymetatarsia with third metacarpal and fourth metatarsal involvement: a case report

Brachymetacarpia and brachymetatarsia are rare congenital deformities resulting from premature closure of the metacarpal and metatarsal growth plates. They may present with cosmetic concerns, functional limitations, or pain, and although typically unilateral and single-bone, bilateral multibone involvement is uncommon. We report a 22-year-old woman with bilateral shortening of the third metacarpal and fourth metatarsal bones. She had no history of trauma, endocrinopathy, or syndromic manifestations. Endocrine laboratory tests were within normal limits. Radiographic imaging demonstrated symmetrical shortening with preserved cortical and joint integrity. Treatment options were discussed with the patient; surgery was planned for the hand deformity but ultimately not performed due to patient preference, while the foot deformity was managed conservatively. This case represents an uncommon bilateral combination of third-metacarpal and fourth-metatarsal shortening. Although genetic testing was not performed, the presence of a similar deformity reported in a sibling suggests the possibility of a familial component.