Cleft foot closure (see text). A, Rectangular flaps are raised on both rays. B, Flaps are raised until skin of entire cleft is removed. At distal tip of longer toe, flap is raised to suture to adjacent toe to make wide toe web. C, If toes spring apart, closing wedge osteotomy is made at base of each metatarsal to centralize bones. D, Kirschner wires are inserted to maintain position. SEE TECHNIQUE 29.5.