Patients with short metatarsals often have associated pain and difficulty in daily activities, such as walking and wearing shoes, as well as a negative psychological impact. This animation demonstrates how Virex Mini-rails are used for lengthening of the first metatarsal. The whole procedure is explained effortlessly step-by-step. First of all, the size of the rails and the half-pins are decided. The position of the half-pins is decided and the rails are prepared. The location of the two half-pins is marked with a surgical pen. A wire is used to puncture the cortex perpendicular to the bone. It is removed and replaced with a half-pin. This step is repeated for a second half-pin. After two pins are placed, the rail is slid over the pins. Using the rail as a template the remaining two pins are inserted. The screws are tightened without locking them, to allow the rail body free movement to align it parallel to the metatarsal shaft. The rail is now removed and a mid-shaft cut is given, making sure the periosteum remains intact. The mini-rails are re-engaged, repeating the process of tightening the screws and adjusting the orientation according to compression or distraction.

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