Bunion Surgery: Which One is Right for You?
Have you scoured the Internet for a solution for the painful bump on your toe? Limited or stopped an activity you love due to pain? Changed your shoe shopping habits to find softer, roomier options?
If you’ve been seeking answers for how to address your bunion, you’re not alone. While estimates vary, up to half of American adults experience hallux valgus,2 the musculoskeletal condition that causes your bunion.
You might have already considered, or even tried, some conservative nonsurgical treatments. Some of these treatments, such as ice, shoe pads, or steroid shots, only work to address the pain you might experience due to your bunion. Other conservative treatments, such as toe spacers and splints, may work in the short-term but fail to offer a long-term solution you are willing to stick with.
And none of these options actually fixes the underlying cause of your bunion.
If you’ve tried and given up on conservative bunion treatments, it may be time to find a doctor to discuss bunion surgery—but which one?
Your Bunion Explained
It is important to understand what a bunion is to better consider the advantages and drawbacks of different bunion surgeries. The 1st metatarsal is a bone in your foot. Its base makes up the edge of your midfoot and its head makes up the bump you know as your bunion. When the 1st metatarsal pronates out of alignment, or turns downward or inward, it causes the bone to poke outward. In addition to creating the bunion on the side of your foot, this movement causes the big toe to curve inward and crowd the other toes.
Different Bunion Surgery Options
Many mild to moderate bunions do not require surgery. However, if you experience any of the following it might be time to talk to your doctor about treatment options:
- Persistent foot or big toe pain
- A noticeable decrease in big toe range of motion
- Inability to find comfortable or correctly fitting shoes because of your bunion
- Altering your activities or general lifestyle due to your bunion
First-time bunion surgery seekers might be surprised to learn that there are many different bunion surgery options available. Bunion surgeries differ in many ways, including the surgical procedure and postoperative recovery experience.
These surgical bunion treatments share the same goal of “removing” your bunion, but technical variations can have implications for scarring, recovery, and postoperative range of motion.
“Open” Bunionectomy and Bunion Osteotomy
There are several, similar bunion procedures within this category.
It’s important to note that open surgeries require the surgeon to make an incision several inches long across the top or medial side of the impacted foot. While this large incision allows the surgeon to see the bony structures they are operating on, it can also lead to increased scarring,3,4 swelling,5 increased trauma to the surrounding tissues,6 and loss of motion and/or stiffness.7
After making this incision, the surgeon uses instruments to shave away the protruding portion of your 1st metatarsal; some procedures also realign your bone structure.
These approaches vary in terms of recovery time, but most open procedures can have a recovery period that is up to 8 weeks longer than the Arthrex Minimally Invasive Bunionectomy.3
The tarsometatarsal (TMT) joint sits at the base of the 1st metatarsal bone, at the opposite end from your bunion. In these procedures, a small plate and screws are used to secure the bones adjacent to the TMT joint, aiming to discourage the bunion from returning.
Fusion techniques require a permanent implant to create fusion and require larger incisions than the Arthrex Minimally Invasive Bunionectomy approach.
The Arthrex Minimally Invasive Bunionectomy
The Arthrex Minimally Invasive Bunionectomy is a true minimally invasive option, meaning surgeons require much smaller incisions to complete surgery. This percutaneous option leads to little to almost no scarring.3,4
Using only tiny incisions, about 1/8 of an inch in length, the Arthrex Bunionectomy realigns your big toe without fusing a joint, which allows your toe to move naturally. This option not only provides cosmetic benefits; the decreased disruption of soft tissue also promotes a better healing environment.5
True minimally invasive surgical options, such as the Arthrex Minimally Invasive Bunionectomy, are clinically proven to achieve the same or better bunion correction results as open procedures.8,9
The Arthrex Bunionectomy may also be a great option for correcting a previous bunion surgery or a bunion that has returned, since the tiny incisions mean surgeons can avoid previous scarring.
1. Jeuken RM, Schotanus MG, Kort NP, Deenik A, Jong B, Hendrickx RP. Long-term follow-up of a randomizedcontrolled trial comparing scarf to chevron osteotomy in hallux valgus correction. Foot Ankle Int. 2016;37(7):687-695. doi:10.1177/1071100716639574
2. Ferrari J. Bunions. BMJ Clin Evid. 2009;2009:1112.
3. Lee M, Walsh J, Smith MM, Ling J, Wines A, Lam P. Hallux valgus correction comparing percutaneous chevron/Akin(PECA) and open scarf/Akin osteotomies. Foot Ankle Int. 2017;38(8):838-846. doi:10.1177/1071100717704941
4. Lam P, Lee M, Xing J, Di Nallo M. Percutaneous surgery for mild to moderate hallux valgus. Foot Ankle Clin. 2016;21(3):459-477. doi:10.1016/j.fcl.2016.04.001
5. Kheir E, Borse V, Sharpe J, Lavalette D, Farndon M. Medial displacement calcaneal osteotomy using minimally invasive technique. Foot Ankle Int. 2015;36(3):248-252. doi:10.1177/1071100714557154
6. Dhukaram V, Chapman AP, Upadhyay PK. Minimally invasive forefoot surgery: a cadaveric study. Foot Ankle Int. 2012;33(12):1139-1144. doi:10.3113/FAI.2012.1139
7. Frigg A, Zaugg S, Maquieira G, Pellegrino A. Stiffness and range of motion after minimally invasive chevron-Akin and open scarf-Akin procedures. Foot Ankle Int. 2019;40(5):515-525. doi:10.1177/1071100718818
8. Lagaay PM, Hamilton GA, Ford LA, Williams ME, Rush SM, Schuberth JM. Rates of revision surgery using ChevronAustin osteotomy, Lapidus arthrodesis, and closing base wedge osteotomy for correction of hallux valgus deformity. J Foot Ankle Surg. 2008;47(4):267-272. doi:10.1053/j.jfas.2008.03.002
9. Raikin SM, Miller AG, Daniel J. Recurrence of hallux valgus: a review. Foot Ankle Clin. 2014;19(2):259-274. doi:10.1016/j.fcl.2014.02.008
Lapiplasty is a registered trademark of Treace Medical Concepts, Inc. LapiFuse is a trademark of Stryker.