[Secondary correction on the forefoot]

If the results after operation on the forefoot are insufficient, in our opinion this is due to: (1) indications that are not strict enough (cosmetic of semicosmetic indication); (2) inadequate technique: insufficient consideration of the length of the toes and the metatarsus or correction of individual toe deformities instead of homogeneous treatment of the whole forefoot. As our results show, when considering all of these points, we obtain a substantial improvement in these feet. The metatarsal length was corrected by the Helal osteotomy or by resection of the head of the metatarsal bone. When the differences were extreme, the forefoot was corrected following the Lelièvre procedure. Full capacity, however, is reached in only one-third of the cases. From this fact, it must be concluded that first operations should be carried out only when there are functional limitations. If the foot is initially free of pain and there is pain after an operation, however slight it might be, the result is always considered poor.