Anybody had the second metatarsal bone shortened?

[dragonfly]

I am having a hard time finding info on having the second metatarsal bone shortened with surgery. I would really like some feedback from people who might have had this surgery. My podiatrist and I are running out of options for my foot and I am facing the decision to have surgery. I would like to know the recovery time, did the surgery work, as far as getting rid of the pain? As I know surgery should be my very last option, as I can't go back after it is done.

I am having pain in the right ball of my foot. Every night when I take my tennis shoes off, the ball is swollen. And that is after I have worn my shoes from the time I get up and have iced it during the day. The icing doesn't seem to help. My Dr has applied some material pieces on my inserts to raise my big toe/first metatarsal up and that does seem to help with the pain while wearing shoes. But like I said I still have deep pain and swelling that is not normal. I have been dealing with this pain for about 1 year now and just want my foot not to hurt anymore. Any info would be greatly appreciated. Thanks

[Dr. D]

Surgery to shorten the 2nd metatarsal is not that common, but when conservative therapy fails, it is used to alleviate excess pressure under the 2nd toe joint (2nd MPJ). There are many types of surgery to alleviate pain under the second toe, and shortening is generally used when the metatarsal is too long. The concept is that when the metatarsal is shortened, it is also elevated. To demonstrate the theory, I'll use the 1st metatarsal image below as an example. Look at the 1st thumbnail image below to see the metatarsal aligned with the ground and the theoretical cut made in the bone. Please note that this type of cut in the metatarsal is rarely made, generally a V-shaped cut, a diagonal cut or an L-shaped cut is made, this is being used for demonstration only. In the 2nd thumbnail image below, the metatarsal slides back and in the process it is shortened.

The general post-operative course is about 2-3 months. This depends on the type of procedure performed. The first 6 weeks are generally non-weight bearing with crutches with progression to weight bearing with a cast boot or post-operative shoe. Swelling can remain in the area for a number of months following the procedure. The most common complication unique to this type of procedure is a transfer lesion. A transfer lesion simply means that once the 2nd metatarsal has been elevated, the weight is transferred to another metatarsal head and pain and/or a callus may develop in that area.