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Bunion Surgery: Lapidus

Type of Procedure: Outpatient
Length of Procedure: 1 hour
Anesthesia: General or IV sedation with regional block

Hallux valgus and bunions

A bunion is one problem that can develop due to hallux valgus, a foot deformity. The term “hallux valgus” is Latin and means a turning outward (valgus) of the big toe (hallux). The bone which joins the big toe, the first metatarsal, becomes prominent on the inner border of the foot. This bump is the bunion and is made up of bone and soft tissue.

A study by the American Orthopaedic Foot and Ankle Society found that 88 percent of women in the U.S. wear shoes that are too small and 55 percent have bunions. Not surprisingly, bunions are nine times more common in women than men.

Most bunions can be treated without surgery. But when nonsurgical treatments are not enough, surgery can relieve your pain, correct any related foot deformity, and help you resume your normal activities.

Once a bunion gets to be irritating or painful, and shoe wear is uncomfortable, surgery may be recommended. If nonsurgical treatment fails, you may want to consider surgery. Many studies have found that 85 to 90 percent of patients who undergo bunion surgery are satisfied with the results.

The Lapidus Bunionectomy

This operation is designed to correct the big toe deformity, the bunion, as well as the deviated position of the 1st metatarsal. In order to correct the 1st metatarsal, a bone cut (an osteotomy) is made. The bone cut is fixed with a plate and screws. The plate and screws typically stay in forever, unless you are able to feel it, when it can be removed.

With all types of bunion surgery, you will be able to wear shoes more comfortably. This does not mean however that you will be able to wear narrow tight shoes. It will take about two to three months for the bone to heal before you can exercise, and another 4 6 months for all of the swelling in the foot to decrease.

General Recovery Facts

  • Expect moderate pain for a few days
  • You are non-weightbearing in a cast or CAM walker for a total of 2-6 weeks after surgery, depending on your bone quality as noted at the time of surgery
  • You may use crutches, walker, or a wheeled device if you need support.
  • You may drive by about 4 days if it is your left foot, and 2 weeks if it is your right foot. A postoperative shoe will be provided for you if it is your right foot for use while driving only.
  • The foot needs to be bandaged for about 3 to 4 weeks
  • You will not be able to get the foot wet while the foot is bandaged
  • You will be able to wear a sneaker type shoe at about 8 weeks

Specific Post Operative Course

Day 1 – 5

  • Foot wrapped in bulky bandage and surgical shoe
  • Ice, elevate, take pain medication
  • Expect numbness in foot 12 24 hours, then moderate pain
  • Bloody drainage through bandage is expected
  • Do not change bandage
  • Do not remove splint

Day 7 – 14

  • First follow up in the office. X-rays taken.
  • Dressing changed bunion bandaging done

2 – 6 weeks

  • Dressing/strapping changed as needed
  • Non weight-bearing until X-rays confirm bone healing