Osteotomy and Ligament or Tendon Repair (Bunion Surgery)

Osteotomy and Ligament or Tendon Repair (Bunion Surgery)

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Osteotomy and Ligament or Tendon Repair (Bunion Surgery)

A bunion is poor alignment of the big toe. It may cause a bony growth at the base of the toe. A bunion can cause pain, swelling, redness, and other symptoms. Osteotomy and ligament or tendon repair is a type of bunion surgery. During this surgery, bone is removed from the toe and nearby tendons and ligaments are made shorter or longer as needed. This allows the toe to align properly. This sheet tells you more about the procedure and what to expect.

Foot and toes showing big toe bent at base, forming bunion.

Preparing for Surgery

Prepare as you have been told. Tell your doctor about all medications you take. This includes over-the-counter drugs. It also includes herbs and other supplements. You may need to stop taking some or all of them before surgery. Also, follow any directions you’re given for not eating or drinking before surgery.

The Day of Surgery

The surgery takes about 60 minutes. You will likely go home the same day.

Before the surgery begins:

  • An IV line is put into a vein in your arm or hand. This line supplies fluids and medications.

  • You may be given sedation to help you relax or sleep. To keep you free of pain during the surgery, you may receive medication to block the nerves in your foot. Or, you will be given general anesthesia. This puts you in a state like deep sleep.

During the surgery:

  • An incision is made on the foot to expose the bunion bump and surrounding tendons and ligaments. The tendons and ligaments that are tight are released (cut).

  • The bunion bump is removed with a bone saw. The big toe bone or the main bone in the foot is shortened and realigned. A pin, screw, or plate is used to hold the toe and foot bones together.

  • The surrounding tendons and ligaments may be tightened. If there is excess tissue, it is removed and the ends are stitched (sutured) together. The incision in the skin is then closed with sutures. Your foot is bandaged.

After the surgery: You’ll be taken to a recovery room. Medications may be given to manage pain. You may wear a brace, surgical shoe, or cast to protect your foot while it heals. The doctor will tell you when you can go home. Have an adult family member or friend drive you.

Recovering at Home

Once home, follow any instructions you are given. During your recovery:

  • Take pain medication exactly as directed.

  • To prevent swelling, sit or lie with your leg raised on one or more pillows. Do this for the first 2 days.

  • Follow your doctor’s instructions about bearing weight on the foot after the surgery. You may need to use a walker, cane, or crutches for a time.

  • You may wear a brace, surgical shoe, or cast for up to a month or longer. Care for this as instructed. Keep it dry by wrapping it in plastic bags when bathing.

  • Avoid sports and other activities until your doctor says it’s okay.

  • Care for your incision as instructed.

  • Do not drive until your doctor says it’s okay.

Call the Doctor If You Have Any of the Following:

  • Chest pain or trouble breathing

  • Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider

  • Pain that isn’t helped by medication or rest

  • Increased swelling not helped by elevation or icing the knee

  • Signs of infection at any incision site such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage

  • Bleeding through the bandages

  • Symptoms of poor circulation, such as toes that look blue instead of pinkish

  • Numbness that doesn’t go away

  • Any other signs or symptoms indicated by your doctor


Keep all follow-up appointments with your doctor. These are to check that you are healing well from the surgery. You may have x-rays to check the healing of the bone. Physical therapy, foot exercises, and other treatments may be discussed at follow-up visits. Full recovery can take at least several months.

Risks and Possible Complications Include:

  • Infection

  • Bleeding

  • Sensitivity at the incision site for months after the surgery

  • Foot pain that doesn’t go away after surgery

  • Numbness in the foot

  • Partial relief of symptoms or failure to relieve symptoms

  • Return of the bunion

  • Risks of anesthesia (the anesthesiologist will discuss these with you)

  • Poor wound healing

  • Poor bone healing (non-union)

  • Breakage of screws or pins

  • Excessive scarring