Hallux Valgus (Bunion) Surgery

The Problem

The bunion, also called a “hallux valgus” deformity, occurs when the big toe begins pointing toward the outside of the foot. This makes the joint at the bottom of the big toe stick out, and sometimes some extra bone also forms in this area to make a bump. In most adults, bunions come from a lifetime of wearing tight shoes, but we don’t know why some people seem more likely to get them than others. We also don’t know why some people that have bunions have a lot of pain and others do not.

If the bunion is too severe, the big toe will crowd the second toe. This creates a hammertoe deformity which may also need to be corrected.

Distal Chevron Osteotomy


Proximal Credential Osteotomy


The Surgery

There are a variety of different bunion surgeries, and we must individualize the choice of the procedure to your particular foot. Most of the time, we have to cut the long bone that leads to the big toe (the “first metatarsal”). This can be done at either end of the bone depending upon how bad the bunion is. We also shave off any extra bone that has formed to eliminate the bump on the inside of the foot.

Some patients have a little arthritis in the joint at the base of the big toe. If the arthritis is too severe, the only way the bunion can be fixed is by fusing the joint (making the two bones grow together). Other patients have no arthritis and have very good motion of the joint to begin with. Because all surgery makes some scarring, it is possible to lose a little motion in the big toe following the bunion surgery.

If any of your small toes are cocked up (hammertoes), we can take care of them at the same time. Usually we take one small joint out of the toe and hold it straight with a pin until it has healed enough that it will stay straight on its own.

Surgery & Recovery

The surgery is done as an outpatient (you do not need to be admitted to the hospital).

Day of the Surgery: You will have a tight ACE wrap on after the surgery to control bleeding. YOU SHOULD TAKE THIS OFF 6 HOURS AFTER YOUR SURGERY. Leave the bandage underneath in place.

1-3 Days, Every Week for 8 Weeks: Because the first dressing is put on tightly, we need to see you in the office within the first few days to put a new one on. We then see you every week for 8 weeks to put on new dressings. These hold the toe in the proper position and keep the swelling down. If you have a pin in the small toe, it comes out at 4 weeks. You can walk in a hard-soled shoe we will give you.

2 Months: We will let you return to regular shoes. We usually check you again a couple more times after you do to make sure the toe is in good alignment.