Bunion Surgery Options Explained

In this video we outline what you should know about when choosing a bunion surgeon.

UFAI's surgeons are nationally recognized leaders in permanent bunion correction. Decades of experience and tens of thousands of successful surgeries assure the very best possible outcome.

Our methodologies not only eliminates pain but leave virtually no scarring. Surgeries are performed on an out-patient basis in our state of the art surgery centers.


Remember, there isn't one type of surgery that works for everyone! UFAI's the only practice in the West certified to perform every type of bunion surgery so you can get the bunion surgery that's truly right for you.

Barbara discusses her recent lapidus bunionectomy performed at University Foot and Ankle Institute.

Bunion surgery may be recommended when less invasive treatment options aren’t successful. Many bunions surgery candidates experience:

  • Severe foot pain when walking, even when wearing comfortable shoes.
  • Inability to bend or straighten their big toe
  • Chronic swelling and inflammation that doesn’t respond to medication
  • Foot and toe pain that limits everyday activities


Learn how UFAI evaluates the severity of Bunions and Hallux Valgus here.


The primary goal of bunion surgery is to correct the deformity and the eliminate pain. If you had bunion surgery and are still in pain, please consult your surgeon or schedule a consultation with us to determine what needs to be done to correct your surgery. Nobody should have to live with bunion pain after undergoing bunion surgery.


Typical recovery time for bunion surgery is 4-6 weeks.


There are 44 different types of bunion surgeries but only a handful have proved to be truly effective, they include:


Austin or Chevron Procedure Long Arm Osteotomy

Austin Bunionectomy, University Foot and Ankle Institute

This is one of the most commonly performed bunion surgeries. An osteotomy, or bone cut, is made on the metatarsal head, just behind the big toe joint. This “V” shaped cut (when viewed from the side) allows the first metatarsal to shift laterally toward the second metatarsal bone. The bones are held together in their newly corrected position with two screws. Although the screws may not be needed after the bone is healed, they are often left in place to avoid a re-occurrence of the bunion.


The patient is typically in a walking boot weight bearing immediate after surgery for 5 to 6 weeks. Once the bone has healed, they can transition to regular shoes and activities.


This is a strong and predictable procedure and is commonly used on active patients younger than 50 years, with mild to moderate hallux valgus.



Scarf Bunionectomy

scarf bunionectomy

With the Scarf osteotomy, surgeons make a long “z” shaped cut on the first metatarsal allowing for the realigning the bones. Two screws hold the bones in their newly corrected position until the bone heals.


Patients are typically in boot with partial weight bearing and on crutches for six weeks. Scarf bunionectomy is a powerful procedure that is used to correct severe hallus valgus deformities.


Akin Bunionectomy

This surgery is most frequently done as an adjunctive procedure and is rarely done on its own. In some cases the angulation deformity of the great toe is so severe (big toe is bowed out) that an adjunctive procedure is needed. Once the initial surgery is completed, the surgeon examines the great toe. They will ensure that it is straight enough and appropriately spaced from the 2nd toe.


If additional correction to the big toe is needed, an Akin osteotomy is performed. Using an angular cut, a triangular wedge of the big toe bone is removed. The wedge is then closed allowing the big to shift away from the 2nd toe. The bones are stabilized with a screw while the bone heals. This additional procedure does not add to the healing time of the main surgery.



Lapidus Bunionectomy

Lapidus bunionectomy

The lapidus bunionectomy allows for the entire 1st metatarsal to be repositioned with the most ideal correction, back to its natural state. An incision is made on the top of the foot and the first metatarsal-cuneiform joint is removed in a “pie wedge” manner. This allows for the entire 1st metatarsal to shift toward the 2nd metatarsal, in a correct position. The bones are stabilized in their corrected position with 2 small screws and/or a plate while they fuse together.


This procedure has the lowest risk of re-occurrence of the bunion because the lapidus bunionectomy addresses the source of the bunion deformity (a loose/hypermobile 1st metatarsal and cuneiform joint). The Lapidus procedure is ideal when the deformity is moderate to severe or there is a significant amount of hypermobility.


Our bunion surgeons have improved this procedure and reduced time needed to be non-weight bearing after this procedure from six weeks to just two weeks with the following techniques: stem cell bone marrow concentrate is used to assist the natural healing process and by better supporting the bones (plate secured with screws), weight bearing is possible immediately after surgery.



Opening Wedge Bunionectomy

A bone cut is made along the first metatarsal and a wedge of bone is placed in the bone cut to correct and close the abnormal angle between the 1st and 2nd metatarsals. Donor bone graft or bone harvested from the patient can be used for this correction. A special small plate with screws is used to stabilize this correction. Post surgery, patients are usually in a cast non-weight bearing on crutches for six weeks.



Tightrope with Austin Bunionectomy


In some cases the bunion deformity is so severe that need a more complex surgery is needed. But if a non-weight bearing, long recovery and is not an option for the patient. then a Tightrope procedure can be performed as an adjunct to an Austin Bunionectomy.


First, an Austin procedure is completed. After that, to further increase the shift of the 1st metatarsal bone, your UFAI surgeon performs a Tightrope procedure. A thin fiber-wire is strung between the first and second metatarsal and tightened – forcing the big to toe properly realign.


Typical recovery is crutches and a boot with partial weight bearing for six weeks.



McBride Bunionectomy

The McBride bunionectomy is not commonly performed as it involves removing the bony bump without cutting the bone and shifting it. That being said, it is used when there is a very small bunion or if the patient is a poor surgical candidate that may not heal well from an osteotomy (bone cut). While the McBride bunionectomy is an acceptable procedure, it does not provide the same type of correction, as do procedures involving an osteotomy.


Revision Bunion Surgery

Many patients come to University Foot and Ankle institute and after previous bunion surgeries have proved unsuccessful. We see patients suffering and in pain from previous treatments, with unsightly deformities; they are devastated that the time, money and discomfort put forth has resulted in a failed surgery.

We truly understand your pain and want to help you. Our surgeons have years of experience performing bunion revision surgeries; they are some of the most sought after bunion revision surgeons in the country.


Browse our patients' before and after photo gallery of bunion surgeries here.



UFAI, the Best Choice for Bunion Surgery


University Foot and Ankle Institute is at the forefront of bunion correction. We pride ourselves on educating patients about their foot condition and providing caring, appropriate treatment.


Our modern foot and ankle physical therapy services allow you to get moving faster and safer. Since foot and ankle therapy is specialized, we work with our therapists to make sure they understand each patient’s specific needs and how to make a rapid recovery.


All this means a safer, shorter, happier and less painful recovery for our patients with the advantage of world-class bunion educators and specialists.

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