Surgical procedure to correct the bony prominence formed by the outward deviation of the big toe, including osteotomy (bone cutting) and soft tissue release techniques.
Indication
- Painful bunion unresponsive to conservative treatment (proper footwear, orthotics, physical therapy)
- Progressive deformity, pressure on adjacent toes, or overlapping (overlapping second toe)
- Gait disturbance and metatarsalgia (pain in the forefoot sole)
- Recurrent skin irritation, bursitis, or infection over the bunion
- Restricted joint movement and swelling affecting daily activities
- Radiographically advanced intermetatarsal angle (typically 13°+) or hallux valgus angle (15-20°+)
Preparation
- Weight-bearing foot X-rays determine the severity of the deformity; appropriate osteotomy type is planned
- Blood tests, ECG; vascular and diabetes evaluation in suitable cases
- Fasting for 6-8 hours before the procedure (depending on anesthesia type)
- Blood thinners are adjusted with physician approval if used
- Planning for the special sandal and activity restrictions to be used postoperatively
How it's performed
- General, spinal, or ankle block (regional anesthesia) is preferred
- Through a small incision on the inner edge of the big toe, the bunion bony prominence (medial eminence) is removed
- Osteotomy technique is selected based on deformity severity: distal (chevron / Mitchell) — mild-to-moderate deformity, proximal — moderate-to-severe deformity, Lapidus (1st tarsometatarsal fusion) — unstable or advanced cases
- The bone is cut, repositioned to the desired alignment, and fixed with screws or plates
- Soft tissues are balanced; the lateral joint capsule is released if needed and the medial capsule is tightened
- The skin is closed, sterile dressing and a special postoperative orthopedic sandal are applied
Post-procedure
- First 2 weeks: foot elevation, ice, and wound care; most patients are discharged the same day
- Depending on osteotomy type, walking with heel-bearing weight in a special sandal for 4-6 weeks
- Radiographic union check at 6 weeks; gradual transition to normal footwear thereafter
- Physiotherapy: toe mobility exercises, balance and muscle strengthening (4-12 weeks)
- Full recovery and return to normal footwear typically 8-12 weeks; vigorous sport 3-6 months
Risks
- Infection, wound healing problems (especially in diabetes)
- Recurrence of deformity — more frequent when an inappropriate technique is chosen
- Nonunion (pseudoarthrosis), nerve sensitivity, or numbness
- Overcorrection (hallux varus — inward deviation of the big toe)
- Joint stiffness, transfer metatarsalgia (pain from increased pressure on adjacent toes)
FAQ
My bunion does not hurt; should I still have surgery?
Mild bunions that do not cause pain or affect daily life generally do not require surgery. Surgery for purely cosmetic reasons is not preferred; the decision is made based on the progression of the deformity and symptoms.
Which osteotomy technique is right for me?
The choice depends on the severity of deformity and joint stability: distal techniques for mild-to-moderate cases, proximal osteotomy for moderate-to-severe cases, and Lapidus fusion for unstable or advanced and recurrent cases. The surgeon plans based on radiographs.
When can I wear normal shoes after surgery?
Depending on bone healing and swelling, transition to wide, comfortable shoes is usually possible after 6-8 weeks. High-heeled or narrow shoes are gradually evaluated after 3-6 months.
Can both feet be operated on in the same session?
It is possible in some cases, but recovery is more challenging since neither foot can bear weight independently. Usually one foot is operated on first, with the other 3-6 months later.
Related Information
Related Medical Services
Other services in the same specialty or with similar indications you may want to explore.
Knee Arthroscopy
Orthopedics & Traumatology
Knee arthroscopy — evaluation and repair of the knee joint through small incisions using a camera.
Shoulder Arthroscopy
Orthopedics & Traumatology
Shoulder arthroscopy — minimally invasive camera-based assessment and repair of the shoulder joint.
Total Knee Replacement
Orthopedics & Traumatology
Total knee replacement — resurfacing of the joint surfaces with prosthetic components in advanced knee osteoarthritis.
Total Hip Replacement
Orthopedics & Traumatology
Total hip replacement — joint replacement surgery in which the hip is reconstructed with an artificial ball and socket.
Meniscus surgery
Orthopedics & Traumatology
Meniscus surgery — arthroscopic repair or partial meniscectomy for meniscal tears of the knee.
Carpal Tunnel Surgery
Orthopedics & Traumatology
Carpal tunnel surgery — release of the transverse carpal ligament for numbness and pain caused by median nerve compression at the wrist.
Scoliosis Surgery
Orthopedics & Traumatology
Scoliosis surgery — correction of lateral spinal curvature with instrumentation and fusion.
Trigger finger surgery
Orthopedics & Traumatology
Trigger finger surgery — release of the A1 pulley to relieve catching and locking of the finger.