Incision Make curved incision 5cm long on medial aspect of joint begin proximal to IP joint curve dorsally to medial border of EHL end 2.5 cm proximal to MTP joint on medial foor Deep Dissection Disect through subcutaneous tissues and fascia Laterally retract medial branch of first dorsal metatarsal artery and medial branch of dorsomedial nerve (branch of superficial peroneal nerve) Disect fascia down to bursa over medial aspect of metatarsal head Make racquet-shaped flap/incision through fascia and into joint base of the flap should attach at base of proximal phalanx