Surgery

A bunion (hallux valgus) is an enlargement of bone or tissue around the joint at the base of the big toe (metatarsophalangeal joint). Bunion surgery generally involves making an incision in the top or side of the big toe joint area and removing or realigning soft tissue and bone. The goals of surgery for bunions are to:

• Relieve pain and restore normal alignment to the toe joint.
• Restore, as much as possible, normal weight-bearing distribution to the foot.
• Allow you to return to normal activities.

You may have to consider surgery if your bunion results in persistent, severe pain that limits your daily activities or if you have a severe foot deformity.² For more information on making this decision, see:

Should I have surgery for bunions?

Surgery is not recommended if you:

• Have not tried nonsurgical treatment.
• Have other health problems that make surgery dangerous. If you have diabetes, neuromuscular disorders, or circulatory problems that limit blood flow to your feet, discuss the risks of surgery with your health professional. Such conditions increase the chance of complications after surgery.
• Have unrealistic expectations about the results of surgery (such as being able to wear any kind of shoe).

Athletes, children, and people with certain health problems are generally advised to take a conservative, nonsurgical approach when considering bunion treatment.

Surgery Choices

Bunion surgery

What To Think About

Joint replacement surgery (implant arthroplasty) is not often done to repair a bunion. If your health professional recommends joint replacement, get a second opinion.

Some issues to consider when deciding about bunion surgery:

• The type of surgery used depends not only on how severe the bunion is but also on your surgeon's experience. Look for a surgeon who does many different types of bunion surgery on a regular basis. Each bunion is different, and surgery needs to be tailored to each case. Research does not indicate which type of surgery is best.
• Bunions may return after surgery, especially if you continue to wear narrow or high-heeled shoes.
• A review of bunion surgeries indicates that up to 33% of people who have surgery for bunions are disappointed in the result, despite the pain being less and the toe being straighter.³
• Your expectations may influence your satisfaction with the surgery. For example, although surgery may improve your foot's appearance, those who make appearance their primary reason for surgery are generally disappointed in the results. Discuss your expectations with your health professional.
• Surgery may reduce the flexibility of the big toe joint, which may be a concern if you are active and need a full range of motion in the big toe.
• You will have to stay off your foot for a while after surgery.