How is the Surgery Performed?

There are many operations that can be performed for metatarsalgia. The exact combination of procedures depends on what is the root cause of the pain. Often there is a bunion associated with metatarsalgia. Correction of the bunion can allow better weight bearing through the big toe. This surgery can be reviewed by clicking here.

If there is hard skin in the sole of the foot associated with pain on weight bearing, then surgery can relieve the high pressure that causes both. The same result can sometimes be achieved by an insole, and this is often tried first. However, some people will need surgery if their insole does not relieve their pain, or the insole itself prevents shoes from fitting.

Most operations involve breaking a bone and resetting it to decrease the proportion of the body weight passing through that ray of the foot. These operations include Weil’s osteotomy, the BRT osteotomy and the OCRA (osteotomie cervicale de raccourcissement axial) osteotomy.

The resetting of the bone is held solid by a small metal screw. The bone will heal over six weeks, when weight bearing can resume again. The incision is on the top of the foot, often between two rays when more than one bone needs to be re-set.

Surgery is carried out under general anaesthetic, but can be carried out with local anaesthetic injections behind the knee or around the ankle. The injections are normally given while you are asleep for your comfort. They can give good pain relief for the first day after the operation. You can go home the same day in the evening.


Risks of Surgery


Bleeding, infection, poor bone healing, poor skin healing, injury to tendons, injury to nerves, recurrence, and a need for further surgery.

There is a small risk of blood clots in the legs or lungs (DVT and PE), and there are also risks from anaesthesia - the process of being put to sleep for your operation.

Risks of Anaesthesia

The injection behind your knee is given using an ultrasound machine to guide the needle. There is a less than 1% chance of injury to the nerve. General anaesthetic also carries risks. These risks are proportional to your general health. You will need to be assessed for your fitness for surgery and an Anaesthetist will be able to advise you on your individual risk.

weil’s osteotomy

OCRA osteotomy

BRT osteotomy

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