Bunion Surgery

Most people with bunions find pain relief with simple treatments to reduce pressure on the big toe, such as wearing wider shoes or using pads in their shoes. However, if these measures do not relieve your symptoms, your doctor may recommend bunion surgery but what is the best option?

Deciding to Have Bunion Surgery

After bunion surgery, most patients have less foot pain and are better able to participate in everyday activities.  As you explore bunion surgery be aware that so-called "simple" or "minimal" surgical procedures are often inadequate "quick fixes" that can do more harm than good. Although many bunion procedures are done on a same-day basis with no hospital stay, a long recovery period is common. It often takes up to 6 months for a full recovery, with follow-up visits to your doctor sometimes necessary for up to a year.

It is very important to have realistic expectations about bunion surgery. For example, bunion surgery may not allow you to wear a smaller shoe size or narrow, pointed shoes. In fact, you may need to restrict the types of shoes you wear for the rest of your life.

As you consider bunion surgery, do not hesitate to ask your doctor questions about the operation and your recovery. Some examples of helpful questions to ask include:

  • What are the benefits and risks of this surgery?
  • What are the possible complications and how likely are they to occur?
  • How much pain will there be and how will it be managed?

Be sure to write down your doctor's answers so you can remember them at a later time. It is important to understand both the potential benefits and limitations of bunion surgery.

Bunions are a three-dimensional problem

A common misconception is that a bunion is a simple overgrowth of bone that can be "shaved off."  Bunions are caused by an unstable joint in the middle of the foot which allows the bone (metatarsal) to drift out of alignment causing the underlying bump.  This deformity is actually a complex three-dimensional condition.  The unstable joint allows the bone to drift, elevate, and rotate out of alignment.  This is why many traditional bunion procedures fail.  

There have been over 100 different procedures that have been utilized to correct bunions.  The reason there are so many different modifications is that surgeons continued to search for the answer to the problem.  Traditional osteotomy bunion surgery does not fix the root problem of the deformity.  The traditional osteotomy corrects to dimensions only.  These procedures traditionally started by trimming the bump and shifting the bone.  This is true whether the procedure was performed open or minimally invasive.  The traditional osteotomy does not address the root problem of instability at the base of the bone (metatarsal).  Since the procedure does not root cause long-term there are many issues that can occur including inadequate correction and deformity recurrence.  This inconsistency has led to inconsistent patient satisfaction.

Fix it right the first time

With the 3-D Lapiplasty® technique, the surgeons at the Foot and Ankle Center Nebraska and Iowa of deformity.  Our surgeons are committed to the best evidence-based treatment options for this condition.  As part of our commitment to our patients, we have corrected the Midwest Bunion Center.  Our 5 locations in Nebraska and Iowa are Centers of Excellence in the treatment of bunion deformities.  In fact, two of our surgeons, Drs. Paul and Mindi Dayton, are part of the team that developed in invented the 3-D Lapiplasty® technique.  We continue to strive to improve our outcomes and actively participate in clinical research on bunion procedures.

How the Lapiplasty® Procedure works

The Lapiplasty® Procedure naturally restores your natural anatomy. There’s no need to cut and shift the normal metatarsal bone with an osteotomy (two-dimensional surgery). The entire metatarsal bone is simply rotated and shifted back into position, eliminating the unsightly bump. And, the unstable foundation is permanently secured with patented, titanium technology allowing you to get back on your feet quickly!  Click here for an educational video of the procedure

Balancing the soft tissue around the great toe

In some cases, the soft tissues around the big toe may be too tight on one side and too loose on the other. This creates an imbalance that causes the big toe to drift toward the other toes. Surgery can shorten the loose tissues and lengthen the tight ones. This is many times performed with the 3-D reconstruction.,

For more information on the 3-D Lapiplasty® technique or to find out if you are a candidate for surgical intervention, call our office and schedule an evaluation today.  You can also find more information on 3-D Lapiplasty® technique here.


Another procedure that can correct the bunion deformity in three dimensions is a fusion of the big toe joint.  This has been a well-tested procedure since it initially was described by Dr. McKeever in 1941.  Surgeons preferred this message of correction due to the high efficacy and low recurrence.  The primary candidate for a McKeever bunionectomy is a patient with both a bunion and arthritis within the joint.  This technique is also used often for failed two-dimensional bunion procedures.  This surgical procedure corrects the tri-planar deformity and eliminates arthritis by eliminating the joint.  

In this procedure, your doctor removes the arthritic joint surfaces, remodels the deformity, inserts screws and plates to hold the surfaces together until the bones heal. 

Complications of bunion surgeries

As with any surgical procedure, there are risks associated with bunion surgery. These occur infrequently and are usually treatable — although, in some cases, they may limit or extend your full recovery. Before your surgery, your doctor will discuss each of the risks with you and take specific measures to avoid complications.

 The possible risks and complications of bunion surgery include:

  • Infection
  • A thick, ugly scar
  • Nerve injury
  • Failure to relieve pain
  • Failure of the bone to fully heal
  • Stiffness of the big toe joint
  • Painful hardware
  • Recurrence of the bunion
  • Blood clots
  • Amputation

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