The metatarsals are the long bones behind each toe. The metatarsal behind the big toe is called the first metatarsal, and that behind the little toe is called the fifth metatarsal.
While surgery on the first metatarsal is common (to correct a bunion), surgery on the other metatarsals is quite rare – though it does happen occasionally, usually for the treatment of painful calluses on the bottom of the foot or ulcerations on the ball of the foot.
Surgery consists of cutting the metatarsal just behind the toe, then pinning it in a corrected position. Following the surgery, the patient may need a cast or crutches for several weeks. If a pin is used to hold the bone in place, it is generally removed in three to four weeks – this can be done without a need for an anaesthetic. While healing, putting excessive weight on the foot should be avoided, and walking prematurely can cause the bone to move and heal in an incorrect position. In fact, this is the most common cause of failure with this surgery.
As with all surgery, there are some risks. Possible complications associated with metatarsal surgery include: infection, failure of the bone to heal in its correct position, stress fractures of adjacent metatarsals and excessive swelling. A common occurrence following surgery is elevation of the toe associated with the metatarsal bone operated on.