Surgical Realignment for Bunions (Osteotomy)

Surgical realignment of a bunion, also known as osteotomy, is an orthopedic procedure used to realign the toe joint in patients who have severe bunions.

During surgery, your big toe and foot bones are straightened, and the joint that creates the bunion is positioned in position under the big toe.

Bunions are painful, large bony bumps on the inside edge of your foot at the base of your big toe. A bunion forms when the big toe moves over toward the toe next to it, forcing the joint out of place.

Who is a candidate for surgical realignment for bunions (osteotomy)?

If you have a bunion, your doctor may recommend surgical realignment.

Bunions form for a variety of reasons including:

• Arthritis. 
• Gout.
• Wearing shoes that are too tight.
• Fracturing a big toe.
• Genetics. Family members have had bunions.
• Foot shape that is more prone to developing bunions.

Risks associated with surgical realignment for bunions (osteotomy)

Complications associated with surgical bunion realignment include:

• Infection at the incision site.
• Nerve injury.
• Bone does not fully heal.
• Stiffness of the big toe joint.
• New bunion forms after surgery.

Preparing for surgical realignment for bunions (osteotomy)

Before bunion surgery, your doctor will perform an exam to evaluate your overall health. He or she will take an X-ray of your lungs, perform an EKG to examine your heart function, and order blood and urine tests to check for underlying health conditions.

In preparation for surgery, your doctor will give you detailed guidelines to follow before surgery, including:

• Stop taking medications such as blood-thinning medications at a specified time before surgery.
• Do not eat or drink anything after midnight on the day before surgery. 
• Arrange for someone to drive you home after surgery.

What to expect during surgical realignment for bunions (osteotomy)?

A surgical realignment for a bunion will be performed as an outpatient procedure under general anesthesia. This means you will be asleep during the procedure, but once you recover from the anesthesia, you will be able to go home after the procedure.

During the procedure, your orthopedic surgeon will make an incision over the bunion and will shave off any extra bone on the bunion. Your doctor will then cut into the end of the big toe and realign your foot and toe bones using permanent screws and wires. The medical hardware will hold the bones in the correct position.

Duration of surgical realignment for bunions (osteotomy) recovery

You will likely need to spend a few hours after surgery recovering in the hospital. In some cases, you may need to spend the night in the hospital.

Your doctor will fit you with a special boot that will protect your foot and prevent you from putting too much weight on the bunion while it heals. You will wear this boot for several weeks.

Once you are home, rest, ice, and elevate your foot to help reduce swelling and pain. You will also need to limit how much you walk or use a cane after surgery.

Your doctor will likely recommend physical therapy to strengthen and stretch the foot and toes.

It may take as long as four to six months to fully recover from surgery.

Contact your healthcare provider if you experience any of the following:

• A fever over 100.4 degrees or higher.
• Redness, swelling or bleeding at the incision site.
• Severe pain at the incision site.