Caution—amputation of the hallux is deceptively simple. Surgeons often find that, once the hallux is amputated, they are unable to close the surgical wound without removing the metatarsal head and a portion of the shaft. This will always occur when using a racquet incision encircling the base of the great toe. The dilemma is how to prevent this from happening. The approach, when feasible, should be to develop a long medial or lateral skin flap that will allow for closure over the disarticulated 1st metatarsal head.

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