Medial displacement metatarsal osteotomy for treatment of painful bunionette

A medial displacement metatarsal osteotomy was performed in 23 feet of 16 patients who had painful bunionette deformities. The mean follow-up period was 22 months. Relief of symptoms, e.g., lateral forefoot pain, plantar pain, toe deformity, functional limitation, and shoewear limitation, was achieved. Lateral forefoot tenderness also was relieved. Forefoot width and intermetatarsal four-to-five, intermetatarsal two-to-five, and metatarsophalangeal five angles were consistently decreased. Overall results based on objective and subjective criteria were good in 88%, fair in 4%, and failure in 8%. Complications were superficial wound infection in one case and possible nonunion in one case. This operation is appropriate for the painful bunionette with metatarsal splaying or outflaring with or without intractable plantar keratosis and varus toe deformity.