Metatarsal surgery is mostly performed to treat bunions; it can also be done for patients with rheumatoid arthritis. Surgery on the first metatarsal is most common because the first metatarsal runs behind the big toe, which is the toe most commonly affected by bunions. A bunion is a deformity of the big toe joint that results from bone misalignment or repositioning at the joint. When the joint at the base of the big toe becomes enlarged, friction and pressure are created as it painfully rubs against footwear. Other metatarsals may need surgery if painful calluses or chronic ulcers form on the bottom of the foot due to uneven, excessive pressure.

Metatarsal surgery involves cutting a metatarsal bone, properly positioning it, and fixing it in place with a metal screw or pin. The procedure is usually done on an outpatient basis. After surgery, patients must be careful to keep weight off of the foot while the bone heals. A surgical shoe or even a cast is usually worn to protect the foot. The bone takes two or more months to heal.