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Bilateral congenially short fourth metatarsal bones were osteotomized subperiosteally, held in neutral position for 3 weeks by a small external fixator, and then subjected to slow axial distraction (0.25 mm/12h). The overall treatment time was 11 weeks, and the final increase in length was 14 mm for the left and 12 mm for the right metatarsal bone.
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