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The proximal cut is made perpendicular to the shaft. A second cut is made at a distance and angle that will facilitate thedesired amount of correction. This cannot be determined by radiograph alone and must be evaluated by clinical judgment atthe time of surgery, therefore it is recommended to start with a small amount of bony resection and build-up as required. If adorsiflexion wedge cut is performed, the plate should be contoured accordingly.Reapply the plate and proximally fix with screws. Appose boneends and temporarily clamp or K-wire the distal fragment to theplate. Drill, measure and insert distal screws.Because the metadiaphysis of the metatarsal has relativelypoor blood supply, the healing potential of this osteotomy canbe improved by using local graft. A 3mm burr can create ‘spotwelding’sites in the cortex on either side of the plate and thesecan be filled with calcaneal autograft.The wound is closed in layers. A postoperative splint is required for two weeks followed by a CAM boot foranother 4-6 weeks.Disclosure: The author did not receive any outside funding or grants in support of this work. Neither he nor a member of his immediate family received payments or other benefits or a commitment or agreementto provide such benefits from a commercial entity.