Short first ray as a complication of multiple metatarsal osteotomies.

Multiple metatarsal osteotomy was performed in 50 children and found to be a reliable procedure for treatment of metatarsus adductus in a child. As a prerequisite to the operation, the epiphysis of the first ray should be ossified. During the operation, the epiphyseal plate must be identified and avoided. After the correction, displacement of the bony fragments may be prevented by wire fixation. The consequences of failure to observe these rules were noted in a patient who was observed for 13 years; despite premature arrest of the physis resulting in 2.5 cm shortening of the first ray, he is asymptomatic and gainfully employed; his foot is testimony to Harris and Beath's concept of the dynamic adaptability of the human foot.