Inclusion Criteria:  Clinical diagnosis of lesser metatarsophalangeal joint instability Clinical diagnosis of metatarsalgia Lesser metatarsophalangeal joint instability clinical grades of II to III, which were determined using the drawer test.  Exclusion Criteria:  Previous operatve treatment of the affected lesser metatarsophalangeal joint. Rheumatioid arthritis. Neurologic disorders (e.g., parkinsonism, Charcot's neuroarthropathy…etc.). Postoperative follow-ups of less than 12 months