Bunion surgery generally involves an incision in the
top or side of the big toe joint and the removal or realignment of soft tissue
and bone. This is done to relieve pain and restore normal alignment to the joint. If the
joint is severely deformed, it may be stabilized with tiny wires, stitches,
screws, or plates. There are no guarantees that a bunion surgery will fully
relieve your pain.
Removal of part of the metatarsal head (the
part of the foot that is bulging out). This procedure is called exostectomy or
Realignment of the soft tissues (ligaments) around the big toe
Removal of a small wedge of bone from the foot (metatarsal
osteotomy) or from the toe (phalangeal osteotomy).
Removal of bone
from the end of the first
metatarsal bone, which joins with the base of the big
toe (metatarsophalangeal joint). At the metatarsophalangeal joint, both the big
toe and metatarsal bones are reshaped (resection
Fusion of the joint where the metatarsal bone joins the
mid-foot (Lapidus procedure).
Implant insertion of all or part of
an artificial joint.
What To Expect After Surgery
The usual recovery period after bunion surgery is 6 weeks to 6
months, depending on the amount of soft tissue and bone affected. Complete
healing may take as long as 1 year.
When you are showering or bathing, the foot
must be kept covered to keep the stitches dry.
Stitches are removed
after 7 to 21 days.
Pins that stick out of the foot are usually
removed in 3 to 4 weeks. But in some cases they are left in place for up to 6
Walking casts, splints, special shoes, or wooden shoes are
sometimes used. Regular shoes can sometimes be worn in about 4 to 5 weeks, but
some procedures require wearing special shoes for about 8 weeks after
surgery. Many activities can be resumed in about 6 to 8
After some procedures, no weight can be put on the foot for
6 to 8 weeks. Then there are a few more weeks of partial weight-bearing with
the foot in a special shoe or boot to keep the bones and soft tissues steady as
Why It Is Done
You may want to consider surgery when:
Nonsurgical treatment has not relieved your
You have difficulty walking or doing normal daily
For more information on making this decision, see:
After surgery, your ability to walk and do other activities is
likely to improve. The big toe joint is generally less painful and, as a
result, moves better. After the incision has healed and the swelling has gone
down, the toe may look more normal than before.
Research does not show which type of surgery is best. A review
of bunion surgeries shows that up to 33% of people who have surgery for
bunions are disappointed in the result despite pain being reduced and the toe
being straighter. The reasons are not clear. Some reasons for being
disappointed in the surgery results could be that a person is not able to wear
some types of shoes (such as high heels) after surgery, or that the joint has a
little less motion compared to the other foot.1
Risks of surgery include:
Infection in the soft tissue or bone of the
Side effects from
anesthetic medicines or other medicines used to
control pain and swelling.
Recurrence of the bunion.
outward or upward bend in the big toe.
Decreased feeling or
sensation, numbness or tingling, or burning in the toe from damage to
Damage to the tendons that pull the big toe up or
A shorter big toe, if bone is removed.
movement or stiffness of the big toe joint (may be an expected outcome of some
types of surgery).
Development of a
callus on the bottom of the foot.
What To Think About
Think about the following when deciding about bunion surgery:
Bunions may return after surgery, especially if
you continue to wear narrow or high-heeled shoes.
The type of
surgery used depends on the severity of the bunion and the surgeon's
experience. Look for a surgeon who does many different types of bunion surgery
on a regular basis. Each bunion is different, and surgery needs to be tailored
to each case.
Your expectations may influence your satisfaction
with the surgery. For example, although surgery may improve your foot's
appearance, those who make appearance their primary reason for surgery are
generally disappointed in the results. Discuss your expectations with your
Surgery may reduce the flexibility of the big toe joint,
which may be a concern for active people who need a full range of motion in the
You will have to stay off your foot for a while after