FAQs

  • A bunion (hallux valgus) occurs when the big toe drifts towards the second toe. Over time, the normal position of the bone, tendons, and ligaments changes, resulting in the bunion deformity. Often, this deformity gradually worsens over time and may make it painful to wear shoes or walk.

  • Here is a great place to start!

  • The painful bump that is causing you to seek treatment will be fully evaluated by your surgeon. Often, you will be a candidate for “stich-less surgery” to correct your bunion. If after examining you and closely looking at your x-rays, your surgeon will discuss if a different option would better treat your condition.

    If you have arthritis in your big toe, a metatarsophalangeal fusion (MTP fusion) of your big toe may be more appropriate.

    Also, based on your anatomy, your surgeon may determine a different type of bunion correction (modified Lapidus procedure) would be best for you. Your surgeon will discuss the best option for you.

  • Most insurances will cover bunion correction. We can provide you with the codes that will be billed to your insurance so you can check with them before the surgery.

  • In order to correct the angle of the bone an osteotomy, or surgically cutting the bone, is performed.

  • For the minimally invasive bunion correction, you will typically have two screws in your first metatarsal. In some cases, if the bunion deformity is not adequately improved with the initial two screws placed in the first metatarsal, one addition screw is placed in the big toe. If you have either an MTP fusion or a modified Lapidus procedure, you will have 2 or 3 strong staples or screws.

  • The screws and/or stables that are placed are safe to remain forever.

  • The metal in your foot will not cause issues when going through security.

  • The metal in your foot will not cause issues when going through security.

  • Most often before people consider surgery for their bunion, they have tried conservative treatments. These options include wide toe box shoes, orthotics, toe spaces, cushions and bunions splints. These can often reduce the pain associated with the bunion but will not correct the deformity.

  • Often, this deformity gradually worsens over time and may make it painful to wear shoes or walk.

  • The surgical options for bunions have improved greatly over time. The bunion surgeries we offer today have a much lower recurrence rate than previous surgeries.

  • It is rare that your bones will not heal after bunions surgery. If your bones do not heal and you have pain associated with this, a revision surgery may be necessary.

    We know there are some conditions that can contribute to bones not healing. Smoking, poor circulation, vitamin deficiencies, and walking on your foot before you are instructed to do so can contribute to your bones not healing.

  • In some instances, just shaving the “bump” off is the right surgical option. Often, shaving the “bump” off is done in addition to the minimally invasive bunion correction. Your surgeon will determine this based on your exam and your x-rays. We will offer you the surgical procedure that will provide you with the best result and the least amount of downtime.

  • A bunion (hallux valgus) is different than big toe arthritis (hallux rigidus). Having your bunion corrected will not definitively prevent you from getting arthritis in your big toe, as these are two separate conditions.

    However, improving the angle of your big toe may help to avoid damage to the cartilage in your big toe joint. If in the future, if you had pain in your big toe and were diagnosed with arthritis in that joint you may require a surgery for this.

  • Bunions often occur in both feet. If you desire surgery on both feet, this will require two separate surgeries. You will not be allowed to put any weight on your foot after surgery for at least two weeks and this is very challenging to accomplish when both feet are involved. In order to provide a more reliably successful surgical outcome, we will allow you to heal from your first surgery and then schedule surgery on the other side approximately 3-4 months after surgery.

Post-Op Care FAQs

  • If you have minimally invasive bunion surgery, you will have 3 or 4 small incisions along the inside of your foot which will be closed with skin glue. Rarely, a dissolvable stitch or two are placed.

    If you have an MTP fusion, you will have an incision on the top of your big toe that is approximately 3 centimeters long; if you have a modified Lapidus procedure this incision will be more in the middle of your foot.

  • Your surgery will take less than an hour. You will meet with your anesthesiologist the morning of surgery and they will devise a personalized anesthesia plan for you. Typical a combination of nerve block and “twilight” sedation is used.

    If you have any specific concerns regarding your anesthesia we can arrange an appointment with the anesthesia team prior to the day of your surgery to ensure your operative day is a stress free as possible.

  • If your surgeon determines that you are a candidate for minimally invasive bunion surgery, you will be able to start walking on your foot in a hard soled post operative shoe approximately 2 weeks after surgery.

    If you are not a candidate for minimally invasive surgery and require either a modified Lapidus procedure or a first metatarsophalangeal (MTP) fusion, you will be able to being weight bearing at approximately 6 weeks after surgery.

    You should obtain crutches or a walker to use after surgery. We can give you a prescription for these or they will give them to you at the hospital. A knee scooter is also very helpful for longer distances. You do not need a prescription for this and most insurance does not cover these. In your surgery folder, there will be information on where to obtain these.

  • Most people do not need any physical therapy after bunion surgery.

  • If you have surgery on your left foot and drive a standard automatic transmission vehicle, you may drive once you are off any narcotic pain medication you were taking. If you have minimally invasive bunion surgery, you will be cleared to drive once you are fully weight bearing in the stiff soled shoe we will provide for you. For most people this will be somewhere between 2-3 weeks after surgery.

    If your surgeon determines that a different surgical option is best to correct your bunion, your weight bearing may be delayed until 6 weeks after surgery; so, you would not be able to drive until after 6 weeks. This information will be discussed with you at your preoperative visit so you can plan your life with this information in mind. We do suggest that prior to driving you take a drive around a less trafficked area and are comfortable applying the break in an emergency; fear over injuring your foot or fear of pain may cause you to hesitate.

  • After your surgery we will place a soft dressing and a hard soled sandal. The hard soled sandal will provide protection to your foot, and it is best if you wear it all the time. Your dressing should be left in place until your first post operative appointment. If your dressing should be come wet or soiled, please call our office and we will arrange for you to come in and have it changed.

  • Due to the minimally invasive nature of this surgery, the pain is much less than other bunion surgeries. Your surgeon will take into consideration your medical history, other medications, past experiences with pain medication when devising a post operative pain management strategy for you. We have had great success with a non-narcotic pain protocol which helps them avoid the side effects of opioid pain medications and provide superior pain relief.

    Even with pain medications, you will still have pain. It will be the worst the first two days after surgery. Ice and elevation are extremely helpful in conjunction with the medications.

  • Each person’s tolerance for pain is different. Your surgeon will devise a post operative pain strategy for you. All of the medications we prescribe are to be taken as needed. If you are not having significant pain, you can reduce the amount or stop taking them depending on your level of pain. You will receive a phone call the morning after surgery to check on you and make sure your pain medications are managing your pain.

  • After your surgery we will place a soft dressing and a hard soled sandal. The hard soled sandal will provide protection to your foot and it is best if you wear it all the time. Your dressing should be left in place until your first post operative appointment. If your dressing should be come wet or soiled, please call our office and we will arrange for you to come in and have it changed. Most of the time, after your first post operative visit at 2 weeks, you will no longer need a dressing on your foot and can wear a sock.

  • Your ability to return to work will be dependent on many factors. We want to help you get back to work as soon as possible while allowing you time to heal to have a good outcome. Discuss with your surgeon the type of work you do and they will help you devise a post operative return-to-work plan that meets your needs and allows you time to heal. This can always be adjusted after surgery depending on how you are doing. People often need paperwork filled out for their employers so please discuss this with us at your visit as well.

  • Bones take 12 weeks to heal completely. If is safe for you to being walking on your foot before this time, and your surgeon will closely monitor your x-rays at your follow up appointments and discuss your progress. Your surgeon will tell you when you can begin walking in the hard soled post operative shoe.

  • Once you are able to be weight bearing we will want you to take it easy at first. The next few visits after you are allowed to be weight-bearing, we will discuss what activities you are doing and how you may progress.

    If you have minimally invasive bunion surgery and begin weight bearing at 2 weeks, you will be able to walk short distances around your home without any restrictions in the hard soled post operative shoe. After a week or so of that, most people feel as though they can run short errands (going to the grocery store, out to dinner etc) at 3-4 weeks.

    At 6 weeks, most people are back into their regular shoe and increase their activity as tolerated. Using a stationary bike or elliptical is typically fine to do at 6-8 weeks. Your surgeon will advise you when you can return to any high impact activities you would like but this is likely at 8-12 weeks after surgery.

  • You will be able to shower immediately as long as you keep your dressing dry. If your dressing becomes wet you will need to come to our office to have a new one applied. After your first post operative visit, you will be able to shower and get your foot wet. No dressings are typically needed at this point.

  • If you have minimally invasive bunion surgery, you will be back in your regular shoe approximately 6 weeks after surgery. If you have either a modified Lapidus or first MTP fusion, you will be able to get into a regular shoe at approximately 10 weeks after surgery.

  • You will be able to wear any shoes you would like to once you are completely healed. If you have an MTP fusion, you may find it somewhat uncomfortable to wear heels with a significant height.

  • Once your bones are completely healed our goal is for you to have no restrictions on your activity. You can return to high impact activities once your surgeon determines you are healed sufficiently to do so. This is typically at 10-12 weeks.

  • If you have minimally invasive bunion surgery (“stitch-less surgery”) your incisions will be closed with skin glue and there will be no stitches. Occasionally, there will be the need to place a dissolvable stitch or two, but these will not need to be removed. If you have a modified Lapidus procedure, your stitches will normally be removed at your first postoperative visit.

  • Swelling is normal after surgery and can take several weeks to months to be completely gone. Each person is unique, and this can vary greatly. The swelling is considerably less with minimally invasive bunion surgery. Ice, elevation, and compression socks can be helpful.