Types of Bunionectomy Surgery Explained

The main types of bunionectomy surgery include osteotomies (cutting and realigning bones for mild to moderate bunions), exostectomy (removing the bony bump for mild bunions), and arthrodesis (fusing the joint for severe bunions or arthritis). More complex procedures like the Lapidus procedure address the joint at the base of the toe for severe cases, while minimally invasive surgery (MIS) uses small incisions for a potentially faster recovery.

Osteotomy

• This is the most common type of surgery and involves cutting and realigning the bone.
• It is used for mild to moderate bunions to correct the joint's position.
• Chevron (Austin) Osteotomy: A V-shaped cut is made to shift the bone.
• Scarf Osteotomy: A more extensive cut is made in the bone for moderate to severe bunions.
• Akin Osteotomy: Performed on the toe bone itself, often in combination with other procedures.
• The bones are secured with screws, plates, or pins. 

Exostectomy

• This procedure involves removing only the bony bump on the side of the joint without cutting or realigning the bone.
• It is suitable for very mild bunions and does not correct the underlying toe deformity.
• This can be performed alone or in combination with other surgeries. 

Arthrodesis (Joint Fusion) 

• Used for severe bunions or when arthritis has damaged the joint.
• The surgeon removes the damaged joint surfaces and fuses the bones with plates and screws.
• This eliminates movement in the joint to relieve pain. 

Other Procedures

• Lapidus Procedure: Fuses the joint at the base of the long bone in the foot to correct instability, often used for severe bunions with a large angle between bones.
• Minimally Invasive Surgery (MIS): Uses small incisions to perform the correction, which can lead to a faster recovery and less tissue disruption compared to traditional surgery.
• Keller Procedure: Removes part of the bone and soft tissue at the joint to reduce pain, but does not preserve the joint's function.

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