The authors studied 40 V-osteotomies of the lesser metatarsal performed for chronic intractable plantar keratosis. They discuss the effectiveness of the V-osteotomy for this deformity as well as other findings such as whether or not fixation of the osteotomy yields a better result (i.e., a lower incidence of complications). The results show that the V-osteotomy had limited effectiveness for this condition and resulted in a high complication rate.