Bunion Surgery (Bunionectomy)

Your surgeon will help you get ready for surgery. You may need:

• A physical exam to make sure your body is ready for surgery.
• Blood tests.
• An electrocardiogram (EKG).
• A foot X-ray. You might also need other imaging tests like an MRI or CT scan.

You may have to stop certain prescriptions or over-the-counter supplements and medications before surgery. Tell your surgeon which medications and supplements you take.

Your surgeon will let you know when you should stop eating and drinking (fast) before your surgery. Most people need to fast for eight hours before their surgery. You can take any medications your surgeon says it’s safe to, with a sip of water the morning of your surgery.

On the day of your surgery, you’ll receive anesthesia to make sure you don’t feel any pain. You won’t usually need general anesthesia to put you to sleep during a bunionectomy. An anesthesiologist may use a few different types of anesthesia that numb you anywhere from the waist down or just your foot and the area around it.

What happens during your surgery depends on which type you need. There are four main types of bunion surgery:

• Osteotomy: Your surgeon will make a few small incisions (cuts) in your foot and toe bones. They’ll insert screws or pins into your bones to realign your big toe joint. This is one of the most common types of bunion surgery. It’s becoming more common for surgeons to do minimally invasive osteotomy with smaller incisions, faster recovery times and less scarring.
• Arthrodesis (joint fusion): Your surgeon might perform a joint fusion if arthritis in your foot and toe caused the bunion or if you have a severe bunion. They’ll remove any parts of your big toe joint that have arthritis. Then, your surgeon will place screws into the bones to hold them together. The bones will join together (fuse) into one bone as they heal. Surgeons usually only do joint fusions on the most severe bunions.
• Lapidus: Your surgeon will remove the bunion. Then, they’ll realign your foot by fusing the joint between your first metatarsal bone (the long bone in the middle of your foot) and the medial cuneiform (one of the small bones where your ankle meets your foot). Your surgeon may suggest the Lapidus procedure if you have a severe bunion. It’s also a good option for people with hypermobility in their foot (the bunion makes your toe move too far or become unstable) and younger people with bunions.
• Exostectomy: During this surgery, your surgeon will shave off the bunion. Surgeons will often perform an osteotomy at the same time to reposition your toe. Exostectomy is rare because surgeons can usually only do it on the most minor bunions. Most people who need bunion surgery have a bunion that’s severe enough to need another type of bunionectomy.

Most bunionectomies take an hour or less. How long your surgery will take depends on which type of surgery you need and how far out of alignment your MTP joint is. Your surgeon will tell you what to expect.

After surgery, your surgery team will move you to a recovery room. They’ll keep an eye on you for a few hours to make sure you recover from the anesthesia without complications. They’ll also monitor your vital signs and pain level.

Most bunion surgeries are outpatient procedures. That means you can go home the same day. Plan ahead for someone to pick you up or arrange another type of transportation to get home. You won’t be able to drive after surgery.