Salvage of Metatarsal Lengthening Nonunion with Structural Iliac Crest Autograft

A short first metatarsal can lead to transfer metatarsalgia of the second and third metatarsal heads and is unsightly. Many people elect to undergo a lengthening procedure, but metatarsal lengthening for brachymetatarsia is a deceptively simple operation. Surgery can lead to stiffness or subluxation of the metatarsal-phalangeal (MTP) joint, deformity of the metatarsal, or nonunion at the lengthening site. This case will review a method for salvage of a failed lengthening of the first metatarsal.