For many people with bunions, surgery is an appropriate option when non-surgical treatments have failed to provide adequate pain relief. Bunion surgery—generally referred to as a bunionectomy—is designed to remove the “bump” of the bone, correct the changes in the bony structure of the foot, and correct soft tissue changes that may also have occurred. The goal of bunion surgery is to reduce pain, improve function and decrease deformity to enable the patient to resume normal activities.
Various types of surgical procedures are available to treat bunions, now over 150. In selecting the procedure, Dr. Hoy has taken into consideration the extent of your bunion deformity based on x-ray findings, your age, your activity level, and other factors. The following procedures are offered in this office, cover about 90% of bunion surgery candidates, reflect Dr. Hoy’s training and expertise in doing these procedures since 2000, and described below:
1. Bunionectomy with Soft Tissue Rebalancing
This is the most common bunionectomy performed by Dr. Hoy, for mild to moderate bunions:
After making an incision over the joint of the big toe to gain access to the bunion, Dr. Hoy:
• Removes the bony prominence of the first metatarsal
• Rebalances the soft tissues surrounding the joint
• Closes the incision with stitches and applies a sterile bandage
Recovery. Recovery from this procedure generally takes 8 weeks. Heel weight bearing on the operative foot is permitted, for the first month in a post-op shoe and the second month in a stiff soled regular shoe.
2. Osteotomy for Bunion Correction View Bunion Surgery Procedure Example Video
This is the second most common bunionectomy performed by Dr. Hoy, for moderate to severe bunions:
After making an incision over the joint of the big toe to gain access to the bunion or area of osteotomy, Dr. Hoy:
• Removes the bony prominence of the first metatarsal
• Rebalances the soft tissues surrounding the joint
• Makes a cut in the bone in the first metatarsal and then realigns the bone
• Inserts some type of fixation hardware, typically screws, to secure the realigned bone
• Closes the incision with stitches and applies a sterile bandage
Recovery. Recovery from this procedure generally takes 12 weeks. Heel weight bearing on the operative foot is permitted, for the first two months in a cam walker boot and the third month in a stiff soled regular shoe.
3. First Metatarsal Phalangeal Joint Arthrodesis.
Depending on the severity of the bunion deformity, fusion of the joint (placing together and connecting two bones) may be necessary.
After making an incision at the top of the joint of the big toe, Dr. Hoy:
• Releases the soft tissue surrounding the joint
• Removes the cartilage in the joint
• Realigns the joint to a corrected position
• Inserts internal fixation to secure the joint to allow for fusion
• Closes the incision with stitches and applies a sterile bandage
Recovery. Recovery from this procedure generally takes 12 weeks. Heel weight bearing on the operative foot is permitted, for the first two months in a cam walker boot and the third month in a stiff soled regular shoe.
Referrals
Dr. Hoy may refer patients to another surgeon in the community if their bunion deformity is extreme enough to warrant procedures like the Lapidus Procedure (1st metatarsal-cuneiform joint arthrodesis, aka Lapiplasty), or if the patient is only interested in new minimally invasive procedures that Dr. Hoy does not perform. Dr. Hoy's approach prioritizes satisfactory results with procedures he specializes in, noting that extreme deformities requiring the Lapidus procedure are rare (about 10% of bunion surgery candidates). The Lapidus Procedure involves removing bony prominence, rebalancing soft tissues, cutting and aligning bones, and inserting fixation hardware for fusion, with a recovery period generally taking 4 months, including 6 weeks of non-weight bearing. Dr. Hoy's patients typically present for surgery before the bunion reaches an extreme stage, leading to faster recovery. If you are in pain, early treatment leads to faster recovery. Urgent appointments are available. Read about Conditions We Treat. Request an Appointment online. Call: 206-682-8741 or Contact Us. If you like our content, please link it to your website and Collaborate With Us. Thank you.
Lapidus Procedure (1st metatarsal-cuneiform joint arthrodesis, aka Lapiplasty).
After making an incision over the big toe joint and first metatarsal-cuneiform joint to gain access to the bunion and the joint, the surgeon:
• Removes the bony prominence by shaving the bone (the first metatarsal)
• Rebalances the soft tissues (ligaments and tendons) around the joint to ensure they push and pull properly
• Cuts an angled piece from the adjacent bone (the cuneiform) and the first metatarsal, and aligns the two bones together
• Inserts fixation hardware to secure the joint where the cuneiform and the first metatarsal meet to allow for fusion
• Closes the incision with stitches and applies a sterile bandage
Recovery. Recovery from these procedures generally takes 4 months. During a portion of this period, 6 weeks, weight bearing on the operative foot may not be permitted.
In pain? Don’t wait. Early treatment leads to faster recovery. Urgent appointments available. Read about Conditions We Treat. Request an Appointment online. Call: 206-682-8741 or Contact Us. If you like our content, please link it to your website and Collaborate With Us. Thank you.