The medical reasoning of “cutting the feet to fit the shoes” comes from the book “Huainanzi – Shuo Lin Xun” written by Liu An, the King of Huainan in the Western Han Dynasty and his disciples, which commented on the royal intrigues of the Spring and Autumn Period, saying The book says, “If you are so nurturing and harming what you are nurturing, it is like cutting your feet to fit your shoes, or killing your head to fit your crown”. To trim the foot to fit the shoe literally means to cut the foot down hard to put on a small shoe. It is often used as a metaphor for unprincipled and blind accommodation, and foolishly adapting to the situation. In the fairy tale, Cinderella’s two sisters really used a knife to cut their feet in order to put on the crystal shoes, which was to compete for beauty and to get the prince’s attention. So some people also use it to satirize women for beauty at the cost of physical pain. Literally it is a derogatory term. But in medicine, “cutting the feet to fit the shoes” has its scientific justification. Orthopedic science has a foot disease called “bunion”, manifested as the big toe to the lateral oblique, serious second toe riding across it, the bunion base medial bone protrusion formation, folk also called “big foot disease” (Figure 1). The main cause of the disease is the long-term wearing of high heels, followed by genetic factors. Due to the increase of the first and second intermetatarsal angle and the formation of the medial process, the forefoot widens, making it more difficult to wear shoes, and the medial process is squeezed and rubbed for a long time, forming “bunions”, showing repeated redness, swelling and pain on the inner side of the bunion. With the flattening of the transverse arch of the forefoot, the negative focus of the bunion gradually moves outward to the base of the second and third toes, causing callus and pain at the base of the second and third toes (Figure 2). Bunions tend to occur in middle-aged and elderly people, and are clinically classified as mild, moderate, or severe according to their anatomical pathological changes, mainly based on the bunion angle and the first intermetatarsal angle. For mild and moderate cases, the development of the disease can be partially corrected and controlled by changing the shoe size and width and wearing bunion orthoses to reduce the symptoms. For some patients with moderate to severe bunions, the deformity and pain can affect their daily life and work, so surgery is needed. There are many surgical treatments for bunions, mainly divided into three categories: soft tissue surgery, bone orthopedic surgery and soft tissue combined with bone orthopedic surgery, and the removal of the medial bone flank, also known as chipping, is one of the basic steps of each surgery. Each surgical procedure has its corresponding clinical indications, which need to be strictly mastered by orthopedic or foot and ankle specialists and planned carefully before surgery to ensure good postoperative results (Figure 3). Minimally invasive osteotomy has fast postoperative recovery, but small indications, incomplete treatment and easy recurrence after surgery are also its biggest drawbacks, so patients and doctors should choose rationally. In addition to bunions, congenital polydactyly, congenital megalodontia, megaloplasia, and other foot diseases require surgical treatment, and “cut-to-fit” surgery is performed for aesthetic and functional reasons. Figure 1 Dorsal view of bunion: bunion with outward slant, second toe straddle with dorsal wear, and medial protrusion Figure 2 Palm view of bunion: second and third toe base callus, forefoot widening Figure 3 Post-operative bunion deformity correction