Bunion Surgery (Bunionectomy)

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.

Bunionectomy can also correct or remove tailor’s bunions (bunionettes). These growths are similar to bunions. But they form on the MTP joint on your pinkie (little) toe.

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 walking is extremely painful and other treatments haven’t helped.

Benefits/risks

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

Bunion correction is safe and effective. Complications are rare, but can include:

• Blood clots
• Infection inside your foot or at your surgery site
• Nerve damage or numbness
• Scarring
• Blood vessel damage that can cause long-term swelling
• The bunion coming back (bunion recurrence)
• Bones not healing together properly (nonunion)

What happens during this procedure?

You’ll need a foot X-ray, blood tests and a physical exam to make sure you’re healthy enough to have surgery. Your surgeon will tell you which medications and supplements you should stop taking before your surgery date. They’ll also tell you how long you should avoid eating and drinking before your appointment.

The day of your surgery, you’ll receive anesthesia to make sure you don’t feel any pain. You probably won’t need general anesthesia to put you to sleep. 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.

Bunion/bunionette surgery usually takes an hour or less. What happens during your surgery depends on which type you need. There are four main types of bunion surgery, including:

• Osteotomy: Your surgeon will make a few small 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 cuts, 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, they’ll 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. This happens when the bunion makes your toe move too far or become unstable.
• Exostectomy: Your surgeon will shave off the bunion. They’ll 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.

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.

Bunion surgery recovery

It takes a few months to recover from bunionectomy. If your stitches aren’t absorbable, you’ll get them 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.

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.

You’ll need to see your healthcare provider for follow-up visits as you recover. They’ll make sure your foot is healing correctly and stays in the right alignment.

Can you walk immediately after this procedure?

It depends on which type of bunionectomy you need. Your surgeon will tell you if it’s OK to put weight on your foot right after surgery. You might need to use crutches or a knee roller/scooter for a few weeks.

Follow your provider’s instructions carefully. Putting too much weight on your foot before your bones heal can undo some types of bunionectomy.

When should I call my healthcare provider?

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

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