Bunion Operation

Written By: Chloe Wilson BSc(Hons) Physiotherapy
Reviewed By: FPE Medical Review Board

Here, we will look at the indications for surgery, the different types of operation commonly used, the recovery process and whether bunion laser surgery is appropriate.  If you want to find out more background information, visit the overview and treatment sections.

Indications for A Bunion Operation

In most cases, a hallux valgus can be treated conservatively i.e. without surgery using simple methods such as changing to wider fitting shoes, using toe splints and medication – find out more in the bunion treatment section. 

However, in some cases bunion symptoms become severe enough to warrant surgical intervention.  People typically benefit from a bunion operation:

• Other Treatments Have Failed: Conservative treatments should be tried first for at least six months and surgery only considered if they have failed to help

Bunion surgery should never be done as a preventative measure or for purely cosmetic reasons as there are risks associated with any type of surgery.

Types Of Bunion Operation

Surgery for bunions is carried out by an orthopedic surgeon and may involve one or a combination of the following:

• Removing part of the bone: either simply shaving off the lump or removing larger portions of bone to correct the angle
• Moving the position of the soft tissues around the bone: making them longer or shorter to hold the toe in a better position
• Changing the position of one of the metatarsal bones:  the long foot bone that attaches to the toe
• Fusing the affected toe joint: removing the damaged bits of bone and holding the toe in place with screws, plates or wire

As every bunion is slightly different, there is no one way to operate on them – your surgeon will evaluate your hallux valgus and decide on the best way to treat it.  The most common bunion operations are:

1. Exostectomy (Mild cases)

An exostectomy bunion operation is where the bump on the toe joint is removed, often referred to as being shaved off.  This is only done with mild bunions as it doesn’t correct the position of the toe, it simple removes the lump. One example of this is the Silvers Procedure

3. Soft Tissue Realignment (All Cases)

In most cases, bunions are associated with tightening of ligaments or tendons that pull on the bone, causing it to drift out of normal alignment.  During soft tissue realignment bunion surgery, loose tissues are shortened and tight tissues are lengthened. 

In virtually every type of bunion operation, there will be some surgery on the tendons and ligaments as part of the procedure. 

5. Excision Arthroplasty (Severe Cases)

Also known as a Resection Arthroplasty or Keller’s Arthroplasty, this bunion surgery involves removing the damaged portion of bone at the toe joint which leaves a space.  The soft tissues are held together with wire until scar tissue forms a false joint in the space. An excision arthroplasty bunion operation is usually only carried out in the elderly or with severe arthritis.

Some bunion operations combine a number of these techniques into one, such as the Lapidus Procedure where the toe is straightened with a combination of osteotomies to removed damaged sections of bone, realignment of the soft tissues and fusion of the first tarsometatarsal joint (metatarsal head and the midfoot) with the bones being held together with screws until new bone grows.

What Happens During Bunion Surgery?

Bunion operations are usually carried out as an out-patient meaning you can go home the same day. 

You might be given a general anaesthetic, where you are put to sleep, or an ankle block, where you are awake but your foot is numb.  A bunion operation usually takes around 30-60 minutes. 

Recovery Following A Bunion Operation

Bunion Laser Surgery

Many people ask if it is possible to have bunion laser surgery thinking it will cause less damage and scarring, and result in a faster healing time.  In actual fact, there is no advantage in bunion laser surgery over traditional methods. 

Lasers work best for treating soft tissues rather than bone and in most cases, bunion surgery involves operating on the bone. Therefore bunion laser surgery is not appropriate.

What Else Can Help?

You can find out more about bunions in the following sections:

• Bunion Guide: An overview of bunions including common causes
• Symptoms: Includes both classic and less common symptoms
• Treatment Options: Best treatments including orthotics and exercises
• Recovering from Surgery: Recovery guide following bunion operation
• Top Products: Things that can help with prevention or recovery from surgery

Bunions are just one possible cause of toe pain and foot lumps and bumps. If you want to know more about other common foot problems, visit the foot pain diagnosis guide.

Page Last Updated: 01/25/24
Next Review Due: 01/25/26

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1. Foot Pain Guide
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2. Treatment Guide
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3. Bunion Surgery