This technique was prepared by Pisani in 1977 (or the treatment of instability of the medial metatarsal bones. Transversal cutaneous incision dorsally along the projection of the metatarsal necks, the subcutis is dissected longitudinally without touching the vasculonervous and lymphatic structures. Once past the tendon plane che individual metatarsal necks are isolated. Through a short incision above the transverse ligament the EPA is isolated and a hemitcndon is prepared out of it but remains inserted distally. Brought to the surface through the centre of the distal insertion, the tendon is introduced mediolaterally into the previously prepared tunnels. The new ligament must be laid well below the blood vessels and nerves and dorsally to the interosseous muscles. Once tunelled through all the metatarsal necks the EPA is sectioned at its insertion and then like the section protruding from the neck of the 5th metatarsal it is sutured to the corresponding section of intermetatarsal tendon. Any preoperative divergence in the metatarsaT bones must be maintained after the tendon is stabilised. Suturing in layers; immobilisation with elastic bandage. Gradual load after about 40 days.