She was born with a short fourth toe. This caused discomfort and she was displeased with the appearance.

Early post-op: The bone was cut (osteotomy) and a frame was applied for gradual lengtheing. The MTP joint was pinned to prevent dislocation.

\

Subsequent post-op: The bone was lengthened as new bone regenerated in the gap.

Healed ...

... and symmetrical.