Each foot has five metatarsals. These are the long bones of the foot. They connect the toes to the rest of the foot. They also make the ball of the foot. The lesser metatarsals are the bones that connect to the second through fifth toes (not the first, or big toe).
An osteotomy is a cut made in the bone. It is similar to breaking the bone but in a very controlled manner. A lesser metatarsal shortening osteotomy changes the pressure distribution under the ball of the foot, relieving pain. It also can be used to put a chronically dislocated toe back in position.
SURGERY
A one to two inch incision is made over the top of the foot. There are many types of metatarsal shortening osteotomies. Where the incision is made depends on the location of the osteotomy. A bone cut is made using a saw at the end of the metatarsal. The cut is made completely through the bone. After the appropriate amount of sliding has occurred, the osteotomy is held in that position with either pins or screws. The surgeon may also place a temporary wire through the toe itself. The skin is then closed.
COMPLICATIONS
All surgeries come with possible complications, including the risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots.
There also are complications specific to metatarsal osteotomies. Failure of the bone to heal after it has been cut may result in continued pain. This complication typically requires another surgery to get the bone to heal in order to alleviate the pain. Excessive scaring can occur as can recurrence of the deformity.
FREQUENTLY ASKED QUESTIONS
