What is Bunion Removal Surgery?

Your doctor has recommended a bunion foot surgery.
This video will improve your understanding of the procedure.
A bunion is a bump on the side of the foot near the big toe.
Let’s look closer at the foot to understand this problem.

There are 5 metatarsal bones in the front of each foot.  Each one aligns with a toe.

A bunion is caused by the big toe pushing into the other toes.   This happens over time as toes are squeezed in tight narrow toed shoes.
The bunion is the first metatarsal bone sticking out at an angle where it meets the big toe.

Extra bone and tissue grow on the irritated metatarsal making it larger and more painful.

Managing a bunion is easiest the earlier it is diagnosed.
Non-surgical therapies include shoe inserts and padding, physical therapy to improve foot alignment, and wearing shoes that don’t rub or squeeze the toes and bunion.  

Bunion surgery can be recommended when non-surgical treatments have failed or are not an option, when you can’t find shoes to fit, and when bunion pain is limiting your activities.

During bunion surgery, extra bone is shaved from the metatarsal.  For the smallest bunions the procedure may end here.
Most bunions are corrected by also restoring the bone alignment.
Mild to moderate bunions can be repaired by cutting across the metatarsal bone close to the toe.  

The cut end of the metatarsal is then shifted to straighten the big toe.  This is called the Chevron procedure.

For severe bunions the metatarsal cut is made close to the foot joint.  This allows the entire metatarsal bone to be re-positioned, reducing the bump and straightening the toe. This is called the Lapidus procedure.

Bones that have been cut and aligned with bunion surgery are held in position with metal hardware. This can be screws, plates, staples, pins or wire. Some hardware may be left permanently or it may be removed after bone healing is complete.

There are different surgical techniques to correct a bunion. The procedure planned depends on the surgeon and the severity of the bunion. All methods need one or more skin incisions. The incision size and placement varies with each procedure. 

Be sure you understand which procedure is planned for you.
Now let’s look closer at the bunion foot surgery.

The foot to be repaired is marked while you are awake.
You will be given anesthesia to keep you free of pain during the procedure.

One or more incisions are made near the bunion as needed for your repair.
The surgeon works carefully to reach the thick white capsule that cushions the joint.

The capsule is opened to reach the bone.
Extra bone is shaved from the metatarsal and scar tissue is trimmed from the capsule.

To correct the alignment the metatarsal is cut, then moved into position. Hardware is placed as needed for support.

The capsule is repaired.

The surgical area is checked for bleeding and the skin is closed, and a dressing is placed.

After surgery, “speak-up” and tell your care-team if you have unexpected pain or problems.

Most bunion surgeries are outpatient, meaning you may go home the same day.
You will have some pain, bruising and swelling.
You may have pins, a cast and/or a boot to support your bones until they heal.  
You may not be allowed to put any weight on your toe or foot, for 2 to 8 weeks. This will depend on your procedure.  

Pain is managed with a combination of 

  • medication recommended by your surgeon
  • rest with foot elevation 
  • ice (using ice-packs wrapped in a towel, never put ice directly on your skin).

Your recovery will occur in stages. By 6 to 8 weeks after surgery the incisions and bones are healed for most patients. Pins and casts are off. You may be wearing a normal shoe and returning to regular activity.
Full recovery often takes 6 months to 1 year.

This depends on the number of incisions and bone cuts needed for your bunion repair, and how well your bones heal.

For the best results, follow your doctor’s instructions about

  • weight bearing - using your foot to carry your weight,
  • your incisions - keep them clean and dry
  • shoes - no narrow toed shoes or high heels, even after bones are healed.

Make good choices to help your body heal.Eat healthy foods.  Avoid junk food and sugary drinks. Don’t smoke.  And keep your blood sugar under control if you are diabetic   Smoking and high blood sugar both slow healing.

Some bunion surgery risks to be aware of include


  • infection,
  • tendon damage,
  • undesired toe shape,
  • bone nonunion, which means the cut bone fails to heal 
  • a blood clot.

A blood clot is also called a DVT, it can cause serious medical problems.
Certain patients are at higher risk of getting a DVT especially those on birth control pills or estrogen, patients that are overweight, smoke and those with a genetic risk called Factor 5 deficiency.  Steps are taken by your care team to help avoid this complication.  

Symptoms that may persist after recovery include

  • pain,  
  • stiffness in the toe joint,
  • swelling, and
  • numbness or lack of feeling near the surgery site.

Call your doctor if you have a fever, worsening pain, swelling, or redness in your leg, foot or at your incision site. Call 911 if you have chest pain, shortness of breath, dizziness, bleeding that doesn’t stop and any other sign that you may be having a complication from the procedure. 

Hospital admission, medication or surgery may be needed to correct some problems. 

To avoid cancellation or complications from anesthesia or your procedure, your job as the patient is to    

  • not eat, drink or chew gum after midnight, the night before the procedure unless you are given different instructions
  • take only medications you were told to on the morning of the procedure with a sip of water
  • follow instructions regarding aspirin and blood thinners before surgery,

    and arrive on time

You should be ready to verify or confirm your list of medical problems and surgeries, all of your medications, including vitamins and supplements, your current smoking, alcohol and drug use and all allergies, especially to medications, latex and tape.

All surgery and anesthesia have a small but possible risk of serious injury, even some problems very rarely leading to death.

It is your job to ask your surgeon if you have questions before surgery.  Understand how your bunion will be repaired and why, whether or not you will need to be non weight bearing and if so for how long. Be sure you understand the risks and alternatives for this surgery.

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This video is intended as a tool to help you to better understand the procedure that you are scheduled to have or are considering. It is not intended to replace any discussion, decision making or advice of your physician.