Among problems affecting the forefoot, metatarsalgia of the lesser toes is a common cause of consultation in the podiatric clinic. It may be the outcome of numerous disorders but is most frequently associated with mechanical alterations of the forefoot, such as claw toe and insufficiency of the great toe or hallux valgus. It is characterised by plantar pain associated with persistent hyperkeratosis under the head of one or various metatarsals of the foot. When it does not improve with conservative measures such as local relief by means of orthopaedic inserts for metatarsal supports, modification of footwear, the use of flexible orthoses to reduce deformities of the toes, anti-inflammatory treatment or multidisciplinary treatment together with physiotherapists, it may require surgical treatment. However, there continues to be controversy with respect to which is the best surgical technique.
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