Bunion Surgery (Bunionectomy)

What is bunion surgery?

Bunion surgery is a surgical treatment to remove a bunion from your foot. Healthcare providers sometimes call it bunionectomy or bunion correction surgery.

Bunions are bony growths that develop on the inside edge of your big toe joint when something pushes your big toe out of alignment for a long time. They affect the metatarsophalangeal (MTP) joint where the base of your big toe meets your foot.

Other treatments can manage bunion symptoms, but a bunionectomy is the only way to permanently remove the extra growth and realign your foot. Your foot and ankle surgeon might suggest bunion surgery if other treatments don’t relieve your symptoms or walking is extremely painful.

How should I prepare for bunion surgery?

Your surgeon will help you get ready for surgery. You may need:

• A physical exam to make sure your body is ready for surgery.
• Blood tests.
• An electrocardiogram (EKG).
• A foot X-ray. You might also need other imaging tests like an MRI or CT scan.

You may have to stop certain prescriptions or over-the-counter supplements and medications before surgery. Tell your surgeon which medications and supplements you take.

Your surgeon will let you know when you should stop eating and drinking (fast) before your surgery. Most people need to fast for eight hours before their surgery. You can take any medications your surgeon says it’s safe to, with a sip of water the morning of your surgery.

What happens during a bunionectomy?

On the day of your surgery, you’ll receive anesthesia to make sure you don’t feel any pain. You won’t usually need general anesthesia to put you to sleep during a bunionectomy. An anesthesiologist may use a few different types of anesthesia that numb you anywhere from the waist down or just your foot and the area around it.

What happens during your surgery depends on which type you need. There are four main types of bunion surgery:

• Osteotomy: Your surgeon will make a few small incisions (cuts) in your foot and toe bones. They’ll insert screws or pins into your bones to realign your big toe joint. This is one of the most common types of bunion surgery. It’s becoming more common for surgeons to do minimally invasive osteotomy with smaller incisions, faster recovery times and less scarring.
• Arthrodesis (joint fusion): Your surgeon might perform a joint fusion if arthritis in your foot and toe caused the bunion or if you have a severe bunion. They’ll remove any parts of your big toe joint that have arthritis. Then, your surgeon will place screws into the bones to hold them together. The bones will join together (fuse) into one bone as they heal. Surgeons usually only do joint fusions on the most severe bunions.
• Lapidus: Your surgeon will remove the bunion. Then, they’ll realign your foot by fusing the joint between your first metatarsal bone (the long bone in the middle of your foot) and the medial cuneiform (one of the small bones where your ankle meets your foot). Your surgeon may suggest the Lapidus procedure if you have a severe bunion. It’s also a good option for people with hypermobility in their foot (the bunion makes your toe move too far or become unstable) and younger people with bunions.
• Exostectomy: During this surgery, your surgeon will shave off the bunion. Surgeons will often perform an osteotomy at the same time to reposition your toe. Exostectomy is rare because surgeons can usually only do it on the most minor bunions. Most people who need bunion surgery have a bunion that’s severe enough to need another type of bunionectomy.

How long does bunion surgery take?

Most bunionectomies take an hour or less. How long your surgery will take depends on which type of surgery you need and how far out of alignment your MTP joint is. Your surgeon will tell you what to expect.

What happens after bunion surgery?

After surgery, your surgery team will move you to a recovery room. They’ll keep an eye on you for a few hours to make sure you recover from the anesthesia without complications. They’ll also monitor your vital signs and pain level.

Most bunion surgeries are outpatient procedures. That means you can go home the same day. Plan ahead for someone to pick you up or arrange another type of transportation to get home. You won’t be able to drive after surgery.

What are the benefits of bunion surgery?

Most people who have bunion surgery experience significant pain relief when they recover. The surgery also improves big toe alignment and will make wearing shoes more comfortable. Improving your big toe alignment can help you walk and move better.

Is it worth getting bunion surgery?

Your health is like you — totally unique. Only you can choose if you want any kind of treatment, including bunion surgery. However, most people who have bunions that don’t respond to other types of treatment experience noticeable, lasting symptom relief after surgery.

Talk to a podiatrist or foot and ankle surgeon. They’ll help you understand when surgery can be a good option to relieve the symptoms you’re experiencing.

What are the risks or complications of bunion surgery?

Bunionectomy is safe and effective, but complications can happen. Rare complications include:

• Blood clots.
• Infection inside your foot or at your surgery site.
• Nerve damage or numbness.
• Scarring.
• Blood vessel damage that can cause chronic (long-term) swelling.
• The bunion may come back (bunion recurrence).
• Nonunion (delayed or nonhealing bones in your toe after arthrodesis).

How long does it take to recover from a bunion surgery?

It takes a few months to recover from bunionectomy. Usually, you’ll get your stitches out about two weeks after surgery. However, it takes about six to 12 weeks for your bones to heal. You’ll probably have to wear a protective shoe or boot while you recover.

After six to 12 weeks, you’ll start to regain foot function (using your foot normally). You might need physical therapy to help restore your foot’s strength and range of motion. You can resume your usual physical activities after about three months. But swelling may last for six to nine months after surgery.

To ensure that your foot heals properly, you’ll need to see your healthcare provider for pre-scheduled post-operation visits following surgery.

Caring for your surgical dressing

Your surgical care team will wrap your toe in a specific, precise way to keep it stable and supported. Ask your surgeon if it’s OK for you to change your dressing. Many people need to keep their dressing in place for a few weeks until their stitches are removed.

Ask your surgeon how to keep your dressing safe and dry when showering or bathing. You might have to cover your foot in a plastic bag or cling wrap to prevent it from getting wet.

Can you walk immediately after bunion surgery?

It depends on which type of bunionectomy you need. If it’s safe for you to walk or put weight on your foot right away, your surgeon will give you a protective shoe or boot to wear.

Some types of bunion surgery require you to avoid putting any weight on your foot (bearing weight) for longer than others. You might need to use crutches or a knee roller/scooter for a few weeks.

Your surgeon will tell you what to expect. Follow their instructions carefully. Putting too much (or any) weight on your foot before your bones heal can completely undo some types of bunionectomy.

Is bunion surgery really painful?

Having any surgery is painful. You’ll feel pain in a few stages after bunion surgery, especially in the first few weeks as you recover. You’ll feel pain from the surgery itself and pain as your body begins to heal.

Your surgeon will suggest ways to manage the pain. They may give you prescription pain medication, over-the-counter NSAIDs (if it’s safe for you to take them), acetaminophen or a combination of these medications. Your surgeon will tell you how much pain medication you can take, and how much of each kind is safe to use.

When should I call my healthcare provider?

Call your surgeon or podiatrist right away if you experience any of the following issues:

• Your dressing loosens, falls off or gets wet.
• Fever higher than 101 degrees Fahrenheit (39 degrees Celsius).
• Bleeding.
• Signs of infection at your surgery site, including leaking, odor, discoloration, swelling or a feeling of warmth.
• New or worsening pain.

A note from Cleveland Clinic

A bunion might be a small bump of bone, but it can have a huge impact on your ability to move through the world comfortably. If it feels like you’ve tried every treatment and nothing’s worked, it might be a good time to consider bunion surgery. Your podiatrist will help you make the decision that’s best for you, your foot and your overall health.

Ask your surgeon any questions you have. Make sure you’re confident and comfortable with all of your post-op instructions before you go home. It’s important to keep your toe supported and stable while it heals. Your care team won’t get upset if you need them to explain everything to you more than once.