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. Small wires, screws, or plates may be used to hold the bones in place. There are no guarantees that a bunion surgery will fully
relieve your pain.
regional anesthetic that affects only the foot is
commonly used for bunion surgery. A
sedative may also be used during the
- The procedure usually takes an hour or more, depending
on the type of surgery.
- Bunion repairs are usually done on an
There are over 100 surgeries for bunions. Research does not
show which type of surgery is best—surgery needs to be specific to your
condition. More than one procedure may be done at the same time.
Types of bunion surgery
- 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
- Making small cuts in the bones (osteotomy) and moving the bones into a more normal position
- 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 (arthrodesis) of the big toe
- 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. In some cases, it can be 3 to 4 months before you can wear regular shoes. 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
- Bunions: Should I Have Surgery?
How Well It Works
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 about 30% 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).
- Persistent pain and
- Degenerative joint disease (arthritis) or avascular necrosis (disruption of the
blood supply to the bone) after 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
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Ferrari J (2009). Bunions, search date May 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
|Primary Medical Reviewer||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
|Specialist Medical Reviewer||Gavin W.G. Chalmers, DPM - Podiatry and Podiatric Surgery|
|Last Revised||February 24, 2012|