The onset of ectropion is associated with a variety of factors: ① shoe wear: shoe wear is not the only cause of [ectropion, but wearing narrow, high-heeled shoes is thought to be one of the important external causes of ectropion. (2) Genetic factors: Many [ectropion patients have a family history of the disease and develop ectropion deformity at a young age. (③) Structural abnormalities of the foot: certain structural abnormalities of the foot, such as flatfoot syndrome, overgrowth of the second metatarsal, overgrowth of the proximal phalanx of the first phalanx, and inversion of the first metatarsal, can cause ectropion. ④Other causes: improper treatment after trauma, second toe defect, deformed healing of metatarsal fracture, imbalance of foot muscle strength, rheumatoid arthritis, etc. can also occur ectropion deformity. Ectropion manifestation: the first metatarsal head medial bone superfluous formation, friction with the shoe surface to form bursitis, also into bursitis, with the aggravation of the disease late often appear droopy toe, 2 toe riding across, small toe bursitis, plantar callus formation and other symptoms. Although there are two different treatments for ectropion, surgical and non-surgical, the correction of the deformity is still based on surgical treatment. Surgical treatment is an effective way to correct deformity, relieve pain, and restore foot function. The choice of ectropion surgery: so far, there is no single method to treat all ectropion. There are more than a hundred surgical methods for treating [exostoses at home and abroad, each with its own advantages. The surgical method needs to be selected according to the degree of deformity, physical condition, whether there is osteoarthritis, whether the 2 toes are deformed, whether the forefoot is collapsed, and mental status of the patient. Now we introduce several surgical methods commonly used at home and abroad: 1. Soft tissue surgery: mainly consists of 3 parts: ① excision of the medial bone superfluity of the first metatarsal head; ② release of the lateral soft tissue of the first metatarsophalangeal joint, including [medial retractor tendon cutting, lateral joint capsule incision; ③ strengthening of the medial soft tissue of the first metatarsophalangeal joint and joint capsule tightening suture. The main methods are the Silver and McBride procedures, some of which require simultaneous wedge osteotomy of the proximal phalanges of the toes (Akin procedure). This type of surgery is mostly suitable for patients with mild bunion deformity, mainly manifesting as [bursitis symptoms. 2.Bone surgery: bone surgery is generally more thorough, with good results in correcting deformities and low recurrence rates after surgery. The most commonly used distal metatarsal osteotomy at home and abroad is Chevron osteotomy. After herringbone osteotomy of the distal metatarsal bone, the metatarsal head is pushed outward and fixed with a single clincher pin or dowel pin, which can be fixed and stable. It is suitable for patients with mild to moderate enlargement of the intermetatarsal angle. ②Metatarsal stem osteotomy: Scarf and Ludloff osteotomies are commonly used at home and abroad for patients with moderate to severe enlargement of the intermetatarsal angle, with the advantage of complete correction, and the disadvantage that the time to go down is later than that of distal osteotomies, and higher surgical skills are required. (3) Basal osteotomy and fusion of the first metatarsal cuneiform joint: Basal osteotomy is suitable for patients with severe intermetatarsal angle enlargement, because it has the disadvantage of postoperative elevation of the metatarsal head, so it is only used in some special cases. The fusion of the metatarsocuneiform joint is commonly used in patients with instability of the first metatarsocuneiform joint or [ectropion with osteoarthritis of the first metatarsocuneiform joint, and the commonly used procedure is: Lapidus surgery. ④There are three options for patients with arthritis in the first metatarsophalangeal joint ①Keler surgery: for patients who are too old and frail to tolerate prolonged surgery or who require only local pain resolution. ②Arthrofusion: for those who are physically active or prefer sports. ③Artificial metatarsophalangeal joint replacement: for patients who require better post-operative joint movement, easy work and good economic conditions. 3.Minimally invasive surgery with small incisions: It is a kind of bony surgery, in which three 12.5px incisions are made in the distal metatarsal bone to remove the hyperplasia, lateral joint capsule incision, distal metatarsal osteotomy, and after osteotomy, the metatarsal head is pushed to the lateral side, without fixing it with Kirschner pins or dowel pins, but with gauze bandage, which can often achieve satisfactory results clinically. In Europe, the United States and large general hospitals in China, in order to avoid intraoperative blind incision damage to nerves, blood vessels, tendons, and postoperative displacement of the metatarsal bone, they often prefer to fix the metatarsal bone with a Kirschner pin or screw after surgical osteotomy under direct vision.