There are several options for lengthening metatarsals through surgery.
Gradual lengthening involves surgically adding a stretcher device to segments of the bone. The patient then turns the device daily using an external fixator to gradually stretch the bone until it reaches the proper length.
A bone graft often taken from the patient can be surgically implanted to the existing short bone to promote growth. This is generally used when the desired added length is less than one centimeter.
A third option lengthens bone by surgically cutting and shifting the existing bones. This is used when only slight increases in length are desired.