Recurrent metatarsalgia has a multifactorial etiology. The analysis of the cause is critical in planning appropriate treatment. Understanding etiology helps understand the mechanism of prevention, which is the best treatment. Recurrent metatarsalgia is often due to poor technique or poor understanding of the underlying problem. In hallux valgus surgery, recurrent metatarsalgia can be a problem of position of the first metatarsal after an inappropriate or poorly done first metatarsal osteotomy or a problem of gastrocnemius tightness not previously recognized. The best treatment is to restore the normal anatomy but that is not always possible, and surgery on affected rays could be the solution.
Keywords: First metatarsal; Hallux valgus surgery; Lateral ray surgery; Recurrent metatarsalgia.
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