A 56-year-old female patient was hospitalized for bilateral hallux valgus and painful corns on the sole of her both feet with brachymetatarsia (). The plantar pain had become a more severe and serious impediment to walking for 3 years. For physical examination, there were four rigid corns, sized 3 × 3 cm2, at the plantar area of the bilateral second and third metatarsal head. Furthermore, the range of motion of both sides metatarsophalangeal and interphalangeal joint had been lagging about 30%behind last year because the pain kept increasing. Simple radiography demonstrated moderate degrees of hallux valgus, mild brachymetatarsia of first-ray and severe fourth brachymetatarsia in bilateral feet (). Length of each metatarsal is described in []. At first, we did scarf and akin osteotomy under spinal anesthesiafor correcting hallux valgus and lowering the first metatarsal, and then the osteotomy site was fixed by two Barouk screws (Depuy S.A., Lyon, France). Then, Weil osteotomy was performed on the second, third, and fifth metatarsals to shorten adjacent metatarsals. For callotasis, we placed an external fixator (Mini fixator, Orthotech, Korea) on the fourth metatarsal, and then did osteotomy after longitudinal incision on the proximal part of the metatarsal shaft. To maintain the alignment of the interphalangeal joint and prevent the flexion deformity of the metatarsal head, K-wire was inserted from the distal phalanx to the distal part of the metatarsal (). She started a passive range of motion exercise3 day after surgery. On 7 days after surgery, she wore a special foot brace, which help to walking just using hind foot, and start partial weight-bearing. The goal of the 4th metatarsal bone was to target 56 mm to be located on the proximal side of the 6 mm with the 3rd metatarsal head shortened after Weil osteotomy was performed. From the 10th day to the 7th week after the surgery, we sought to extend the length of 5mm 2–3 times a day. After the 8th week after surgery, the length remained the same (), then the external fixator was removed after confirming of callus formation at the post-operative 11th week (). The final length of each metatarsal is revealed in []. Active toe exercise was available from 3 months after the surgery, and foot plantar pain and corn were gradually decreased, leaving almost no trace from about 4 months after the operation. Since then, the patient has been able to wear shoes without pain. 1 year after the surgery, the active range of motion exercise has recovered about 80% of its range. The active joint of the foot movement during the 10 years since the surgery has returned to its normal range in all joins (). Before the surgery, the America Orthopedic Foot and Ankle Surgery (AOFAS) scores finally improved from 52 to 90, and the AOFAS, AOFAS’s first toe score improved from 41 to 88.10 years later, there were no aftereffect from the simple radiography such as metatarsophalangeal osteoarthritis, and so on ().