Kramer osteotomy for bunionette deformity. A, Skin incision at head-neck junction of fifth metatarsal with subperiosteal flaps elevated and retracted. B, Kirschner wire advanced antegrade through incision subcutaneously, exiting at toe. C, Kirschner wire advanced retrograde into fifth metatarsal shaft to hold segment and saw used to smooth subcutaneous contour. (From Lee DC, de Cesar Netto C, Staggers JR, et al: Clinical and radiographic outcomes of the Kramer osteotomy in the treatment of bunionette deformity, Foot Ankle Surg 24:530, 2018.) SEE TECHNIQUE 84.26.