Foot Surgery: Bunions

A bunion is a bony bump. When the distance between the first and second metatarsal bones of the foot is greater than normal, the big toe may turn toward the other toes. A mild bunion may then form causing foot pain and swelling. Bunions are most often found near the joint at the base of the big toe. Bunions tend to run in families. They may cause pain, swelling, and skin irritation. Wearing tight shoes can cause bunions, and can make them worse. Bunions vary from mild to severe and can be treated in many ways. Most bunions can be managed by proper shoe selection and other measures. Most don't need surgery. If pain remains severe and surgery is needed, the surgical methods below may be a choice.

Image of the big toe joint with a piece of bone removed and a scew

Image of the big toe joint

Head chevron osteotomy

The first metatarsal bone is cut. Its head is moved closer to the second metatarsal bone. A screw or pin can be used to hold the first metatarsal bone in position. The bony bump is also removed. To protect your foot, you will need to wear a surgical shoe for a few weeks.

Big toe joint with bone removed and scews

Big toe joint

Base osteotomy

With this procedure, a wedge of bone is removed from the first metatarsal bone, farther back than in the head chevron osteotomy. The bone is moved closer to the second metatarsal bone and held together with screws or a plate. The bony bump is also removed. To heal correctly, your foot may be placed in a cast, shoe, or boot. You may be asked not to bear weight on this foot for several weeks.

Soft tissue repair

This procedure tightens the loose ligaments and tendons, and loosens the tight ones surrounding the bunion. It can be combined with an osteotomy procedure.

Fusion or removal of part of the joint

This is typically only done if there is severe arthritis or damage of the joint itself.