A recent study by Chong et al (2015) reveals that more than 1 out of 4 patient is dissatisfied with conventional bunion surgery at 5 years, with only 1 out of 3 patients completely free of symptoms
Traditional bunion surgery: the 'bone-breaking' procedures.
On this page we provide a few examples of traditional bunion surgery and explain why this approach is not only unnecessary, but potentially harmful.
All surgeons will know that the important structural change responsible for the bunion formation is a displacement of the first metatarsal bone. The primary goal for all bunion surgery is to realign this displaced, but normal, first metatarsal bone. The most common, traditional approach is one of the many different "break-n-shift" techniques. There are 130+ different operations for the painful bunion. There are so many because each technique has limitations. Also, the osteotomy choice can simply reflect the surgeons’ preference.
Below are a few examples of some of the more common, traditional, 'bone breaking' operations. There are many others, that can include "Minimal Invasive Surgery" or the "Swiss Bunion Surgery". These are only a variation, but still bone breaking operations. In all of the examples the bone is cut and moved, while creating a deformity in the normal bone, in an attempt to make the segment appear "straighter". In contrast, the Syndesmosis Procedure does not create a deformity in normal bone, but simply returns the entire segment to their normal anatomical position.
If you are unsure what approach the foot surgeon proposes, for your bunion, ask the provider if the bone needs to be 'cut' (osteotomy) or if a joint has to be 'fused' (made stiff).
Almost always, regardless of which type, the osteotomy creates a deformity within the normal bone.
In our opinion, the osteotomy approach favored by most foot surgeons:
All surgeons will know that the important structural change responsible for the bunion formation is a displacement of the first metatarsal bone. The primary goal for all bunion surgery is to realign this displaced, but normal, first metatarsal bone. The most common, traditional approach is one of the many different "break-n-shift" techniques. There are 130+ different operations for the painful bunion. There are so many because each technique has limitations. Also, the osteotomy choice can simply reflect the surgeons’ preference.
Below are a few examples of some of the more common, traditional, 'bone breaking' operations. There are many others, that can include "Minimal Invasive Surgery" or the "Swiss Bunion Surgery". These are only a variation, but still bone breaking operations. In all of the examples the bone is cut and moved, while creating a deformity in the normal bone, in an attempt to make the segment appear "straighter". In contrast, the Syndesmosis Procedure does not create a deformity in normal bone, but simply returns the entire segment to their normal anatomical position.
If you are unsure what approach the foot surgeon proposes, for your bunion, ask the provider if the bone needs to be 'cut' (osteotomy) or if a joint has to be 'fused' (made stiff).
Almost always, regardless of which type, the osteotomy creates a deformity within the normal bone.
In our opinion, the osteotomy approach favored by most foot surgeons:
- is often unnecessary
- may only partially correct the bunion
- carries the risk of complications
- does not address the problem of foot instability
- creates a disturbance to the normal, natural anatomy of the foot
Akin osteotomy
Austin osteotomy
Hohman osteotomy
Lapidus Operation: joint fusion with screws
The Lapidus operation: joint fusion with plate & screws
Ludloff osteotomy
Mitchell osteotomy
Wilson osteotomy
Scarf osteotomy
Dr. Fellner used the scarf osteotomy (below) for many years providing a patient with a good outcome.
THE VIDEO BELOW IS AN EXAMPLE OF TRADITIONAL OSTEOTOMY AS PERFORMED IN THE OPERATING ROOM. DUE TO THE GRAPHIC CONTENT OF THE MATERIAL VIEWER DISCRETION IS ADVISED