Fig. 2. (A) Schematic drawing of a lateral head fracture of the left great toe showing the fragment attached to the capsule and lateral collateral ligament (LCL). (B) Case 1: anteroposterior radiograph of the left great toe in a 3-year-old boy, taken 6 months after hitting a wall, showing a tiny bony fragment (diameter about 1 mm) on the lateral side of the distal head. He was brought to our clinic because of increasing hallux valgus interphalangeus. (C) During surgery, we found that the cartilaginous portion was larger than we had envisioned (7 mm × 3 mm). It was easy to misdiagnose the fracture because the fragment was mostly cartilage. The bone fragment was flipped by the LCL and it was hard to find the cancellous bone portion. It was necessary to grind the opposite side of the LCL attachment surface to expose the cancellous bone and then to fix it using 2 Kirchner wires with iliac bone graft. (D) A radiograph taken 3 years after surgery showing the bony portion of the fragment had enlarged by ossification. Although the medial side of the fragment showed fibrous union, maintenance of the articular surface was satisfactory due to bony union on the proximal side where iliac bone graft was used. The hallux valgus did not worsen after surgery. (E) A radiograph taken 4 years after surgery showing complete bony union on both sides.