Bunion surgery is customized to the severity of the deformity and may involve one or more procedures:

 

1. Osteotomy (Most Common Procedure)

• The first metatarsal bone is cut and repositioned to correct alignment.

• Types of osteotomy include:

  • Chevron (Mild Bunion) – Small V-shaped cut near the joint.

  • Scarf (Moderate Bunion) – Z-shaped cut along the bone.

  • Lapidus (Severe or Hypermobile Foot) – Fusion of the first metatarsal joint to prevent recurrence.

  • Minimally invasive (MIS) bunion surgery - small incisions

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• The bone is stabilized with screws or plates, which are usually left in place permanently.

 

2. Soft Tissue Realignment

• The tight soft tissues on one side of the toe are released, and loose tissues on the opposite side are tightened to balance the joint.

 

3. Exostectomy (Bunion Bump Removal)

• The prominent bony lump is shaved down, usually combined with osteotomy to prevent recurrence.

 

4. Fusion (1st MTP Joint Fusion)

• Recommended for severe arthritis where joint motion is painful and the deformity is rigid.

 

Surgery is performed under regional or general anesthesia

Before considering surgery, non-surgical treatments can be tried, including:

• Footwear Modification – Wider, well-cushioned shoes reduce pressure on the bunion.

• Orthotics (Insoles) – Help support the arch and redistribute pressure.

• Toe Spacers or Bunion Splints – May provide mild symptom relief but do not correct the deformity.

• Pain Management – NSAIDs, icing, or corticosteroid injections (short-term relief).

If these fail to control symptoms, surgery is the only option to correct the deformity permanently.

Bunion surgery is generally successful, but potential risks include:

 

General Surgical Risks:

• Infection (1–2% risk) – More common in smokers or diabetics. Usually treated with antibiotics.

• Blood Clots (DVT/PE) – Rare, but may require blood thinners in high-risk patients.

• Nerve Injury – Small nerves near the incision may be damaged, causing numbness or tingling.

 

Procedure-Specific Risks:

• Stiffness or Limited Big Toe Motion – More common in fusion procedures.

• Nonunion or Delayed Bone Healing – The cut bone may take longer to heal, especially in smokers.

• Persistent Pain or Swelling – Can take months to settle post-surgery.

• Bunion Recurrence – More likely with severe deformities or poor postoperative compliance.

• Transfer Metatarsalgia – Pressure shifts to the lesser toes, causing new pain in the ball of the foot.

• Hallux Varus (Overcorrection) – The big toe may drift in the opposite direction, requiring further correction.

• Sesamoiditis – Inflammation of the small bones under the big toe can occur after realignment.

• Metal Prominence Requiring Removal – Some patients feel discomfort from the screws/plates, requiring removal.

• Fracture – The cut metatarsal bone is at risk of fracture if excessive stress is placed on it too soon.

• Scar Sensitivity – The surgical site may remain tender or hypersensitive, though this typically improves over time.

 

Long-term studies show 85–90% of patients experience significant pain relief and improved foot function.

Time Off Work

• Desk jobs: 2–4 weeks

• Manual labor: 8–12 weeks

 

Return to Driving

• 6 weeks (automatic car, left foot surgery).

• 8–10 weeks (right foot surgery or manual car).

 

Return to Activities & Sports

• Walking unaided: 6–8 weeks

• Low-impact activities: 3–4 months

• Full sports participation: 6+ months

 

Rehabilitation Timeline

• Weeks 0–6:

  • Wear a postoperative shoe or boot (partial weight-bearing).

  • Keep foot elevated to reduce swelling.

• Weeks 6–12:

  • Transition to normal footwear.

  • Start physiotherapy for strength and flexibility.

• 3–6 months:

  • Return to full function and activities.

  • Minor swelling may persist up to 12 months.

 

With proper rehabilitation, most patients regain pain-free walking and improved foot alignment.