It is not the toe that is problematic, rather the lateral aspect of the foot.
In fact I ought to have asked the question with the name of brachymetapody as opposed to brachymetatarsia since it is both the fourth and fifth metatarsals that are abnormally short.
The patient has had an orthopaedic consultation but surgery is not indicated, hence the nature of my original thread.
Do a video gait analysis from behind - close up on met heads -- is there a transfer from Bojsen-Mollors oblique to transverse axes during propulsion. Metatarsal parabola problems interfere with this, allegedly important function? ---> make orthoses to facilitate it. See this thread for more.
What hurts?
If you put the foot into a shoe can you tell there is a problem?
Does the patient tell you there is a problem?
Mechanically a short lateral foot would decrease the amount of foot lateral to the STJ axis and could potentially increase the chance of lateral instability.
However, this is dependent upon the position of the STJ axis.
Maybe shoe filler to prevent shoe collapse on the foot.
It might not be worth the effort.
Excessive load on the long mets could benefit from a rocker bottom shoe.