We describe the results in seven patients who underwent surgery to lengthen a short first metatarsal via callus distraction. The increased length achieved ranged from 13 to 48 mm, with an average of 20.2 mm. The technique was successful in restoring length and improving symptoms, although several complications were encountered. (J Am Podiatr Med Assoc 98(1): 51–60, 2008)

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