**9. Conclusions**

The literature indicates that tendon lengthening is effective treatment for neuropathic forefoot ulcerations and that the complication rate seems to be low. By healing most forefoot ulcerations and lowering their recurrence rate more than all other treatments, this procedure should lower the incidence of progression of metatarsal ulceration to infection and subsequent amputation. More studies need to be done to confirm tendon lengthening is an effective treatment for Charcot foot and other foot problems and confirm tendon lengthening should be part of initial treatment of diabetic foot problems.
