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February 2, 2025 13 mins

Bunion surgery, also known as bunionectomy, is a procedure to remove bunions, bony growths on the big toe joint. The article details four surgical techniques: osteotomy, arthrodesis, Lapidus, and exostectomy, each with varying recovery times and risks. Post-operative care involves pain management, protective footwear, and monitoring for complications like infection. The decision to undergo surgery should be made in consultation with a podiatrist, weighing the benefits of pain relief and improved mobility against potential risks. Recovery typically takes several months, with full function returning after about three months.

Disclaimer: The content provided in this podcast is for informational purposes only and should not be construed as medical advice. It is not a substitute for professional diagnosis, treatment, or consultation with a qualified healthcare provider. Always seek the advice of a physician or another qualified health provider with any questions or concerns regarding a medical condition. By listening to this podcast, neither its hosts, guests, nor publishers establish a doctor-patient relationship, and no liability is assumed for any decisions made based solely on the information presented.

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(00:00):
Welcome to the Podiatry Insight Hub, the leading informational audio platform for common care

(00:07):
and treatments related to lower extremity.
Get ready for another great podiatry topic in today's post.
Ready, set, here we go.
Disclaimer, the content provided in this audio is for informational purposes only and should
not be construed as medical advice.
It is not a substitute for professional diagnosis, treatment, or consultation with a qualified
healthcare provider.

(00:28):
This is to seek the advice of a physician or another qualified health provider with
any questions or concerns regarding a medical condition.
By listening to this audio platform, neither its hosts, guests, nor publishers establish
a doctor-patient relationship and no liability is assumed for any decisions made based solely
on the information presented.
Okay, so looks like we're doing a deep dive on bunion surgery today.
Yeah.

(00:49):
You've got a ton of research here, everything from like medical journals to personal stories,
even some stuff on that lapiplasty procedure.
I'm impressed.
Yeah, it seems like you're really trying to get a grasp on the whole picture, not just
what the surgery is, but like the different types, how long it takes to recover, even
if there are other things you can try before going under the knife.

(01:09):
That's the goal, really trying to get the full picture.
Yeah.
So maybe we should start with the basics.
I mean, most people have heard of bunions, but not everyone really knows what they are.
Right.
Well, a bunion is that bump you see at the base of your big toe.
It's not just the bump though, it's because the joint that connects your big toe to your
foot is out of alignment.
So the toe starts angling inward.
Gotcha.

(01:30):
So it's that misalignment that causes the pain and problems, not just the bump itself.
Exactly.
The inward angle puts pressure on the joint and that leads to inflammation, pain, stiffness.
And you might even have trouble walking, exercising, or finding shoes that fit comfortably.
Speaking of shoes, some of the stuff you've got here talks about trying wider shoes or
orthotics before considering surgery.

(01:52):
Do those actually work?
They can definitely help you manage the symptoms, especially if you catch it early.
Orthotics can kind of redistribute the pressure and give your foot some support.
And just switching to shoes with a wider toe box can make a huge difference in how comfortable
you are.
So basically, conservative treatments buy you some time.
But it seems like all this research agrees that surgery is the main solution when those

(02:15):
other things aren't enough.
And what's interesting is there's not just one type of bunion surgery.
Right.
There's a whole range of procedures.
Each one with its pros and cons.
One common one I see in your research is an osteotomy.
Osteotomy.
That sounds kind of intense.
It's basically where the surgeon cuts and repositions the bone to fix the alignment
of your big toe joint.
There are actually different types of osteotomies like chevron or scarf based on the shape of

(02:37):
the cut they make in the bone.
And nowadays, surgeons are moving towards doing these minimally invasive faccals, which means
smaller incisions and faster recovery.
Okay, so that's about realigning the joint.
But there's also arthrodesis, which is a totally different approach, right?
Yep.
Arthrodesis is a fusion procedure.
Basically the surgeon permanently joins two bones together to stop the movement in that

(03:00):
joint.
It's usually for really bad cases or when arthritis has done a lot of damage.
It might sound extreme, but it can be the best way to get rid of pain long term.
So we've got realigning with osteotomy and fusing with arthrodesis.
But then there's this lapidus procedure, which seems to be fusing a different joint
altogether.
You got it.
The lapidus procedure targets the joint higher up in your foot, the one between one of the

(03:23):
long bones called the metatarsal and a small bone in your ankle.
It's a more complicated procedure, but it can really get to the root cause of bunions,
especially for people with severe misalignment or hypermobility.
Hypermobility.
What's that?
Basically means your foot joints are more flexible than normal, which can make you more
likely to get bunions, especially if you don't wear supportive shoes.

(03:44):
The lapidus procedure aims to stabilize that overly flexible joint to prevent the bunion
from coming back.
So it's not just about fixing the problem now, but preventing it from happening again
later.
That's really interesting.
It is.
It really highlights how important it is to find the right procedure for your situation
with bunion surgery.
There's also this exostectomy procedure mentioned in some of this stuff.

(04:05):
Sounds simpler.
Is it just about removing that bump?
Exostectomy does involve shaving down the bump, but it's almost never done on its own.
Think of it this way.
The bump is just a symptom of the misaligned joint.
Shaving it off doesn't actually fix the problem, so the bunion is likely to come back.
Makes sense.
So with all these different approaches, how do you even know which surgery is the right

(04:28):
one for you?
That's where a qualified foot and ankle surgeon comes in.
They'll look at your bunion, consider things like how bad it is your age, how active you
are your overall health, and then recommend the best course of action.
So it seems like there's a lot to consider, and you've got a whole pile of info on this
lampoplasty procedure specifically.
Should we take a closer look at that next?

(04:48):
Let's do it.
You seem really interested in lampoplasty, so we can definitely explore what makes it
unique and how it stacks up against the other options we've talked about.
So we were going to look into this lampoplasty thing.
Seems like it's become pretty popular lately, and there's a good reason for that.
It offers some pretty unique benefits over the traditional bunion surgeries.
Yeah.
One thing that stuck out to me was how they talk about it being a 3D correction.

(05:11):
What does that even mean for a bunion?
It's not like it's popping out in every direction, is it?
That's a great question.
You see that bump sticking out, but a bunion is actually a three-dimensional problem.
The big toe joint doesn't just angle inward, it also rotates, and can even move upwards.
Lappoplasty tries to correct all three of those misalignments.

(05:32):
So it's not just about pushing the toe back into place like some of the older surgeries
might have done.
Exactly.
Lappoplasty uses these special tools and titanium plates to realign the bones in all
three dimensions.
And that seems to be a key part of why the correction is so immediate and why it stays
stable for so long.
Speaking of those titanium plates, those seem to be a big part of what makes Lappoplasty
different.

(05:53):
Are they just there to hold everything in place after the bones are fixed?
That's a big part of it.
The plates provide really strong fixation right away, so you can start putting weight
on your foot sooner than with other procedures.
Plus, they're designed to be low-profile so they don't irritate the inside of your
foot.
It's amazing how much surgery has advanced.
Some of these studies even say that 97% of patients kept their 3D correction even 13

(06:15):
months after surgery.
That's pretty impressive.
Those early results are definitely promising, but it's important to remember that longer
term studies are still going on.
It does suggest though that Lappoplasty could be especially good at stopping bunions from
coming back.
That's definitely a plus.
We talked about how recovery takes time no matter what procedure you choose, but it seems
like Lappoplasty might let you get back to some activities faster.

(06:38):
Is that right?
Yeah, the research you've got definitely points to a quicker recovery time with Lappoplasty.
Even like two weeks, a lot of patients can start putting some weight on their foot as
long as they wear a protective boot.
And over the next four to six weeks, they can gradually do more and more and start wearing
regular shoes again.
So you're not exactly running marathons right away, but it sounds like you're not totally

(07:00):
stuck on the couch either.
That's the idea.
And by four to six months after surgery, most patients can go back to most of their normal
activities like exercise.
Obviously, everyone heals differently, but this faster timeline is a big draw for a
lot of people who are considering Lappoplasty.
It does sound promising, but I have to ask about the downsides.
Every surgery comes with some risks, right?

(07:20):
Of course.
And the stuff you've gathered is pretty upfront about that.
The possible complications with Lappoplasty are similar to any bunion surgery, things
like infection nerve damage, slow healing, and the chance of the bunion coming back.
So it's not like a miracle cure.
Even with all this advanced technology, you still have to be realistic and consider the
risks.
Exactly.

(07:41):
And a huge part of minimizing those risks is doing exactly what your surgeon tells you
to do after the surgery.
Stuff like keeping the incision clean, wearing that boot and not doing too much too soon
are super important for healing properly.
It sounds like the surgeon and the patient really have to work together to get the best
outcome.
You got it.
The surgeon brings their expertise to the operating room, but the patient has a huge role in making

(08:04):
sure the recovery goes smoothly.
So let's say someone is seriously thinking about bunion surgery.
What should their first step be?
The most important thing is to talk to a qualified foot and ankle surgeon who's experienced
with different techniques, including Lappoplasty.
That way they can give you unbiased advice that's tailored to your specific needs and
goals.
Makes sense.

(08:25):
You want someone who can look at your situation and recommend the best option for you, not
just push one specific procedure.
Right.
It's about finding what works best for you.
Don't be afraid to ask tons of questions during your consultation.
Make sure you understand the risks and benefits of each option and feel good about the surgeon
and the plan they have before you go ahead with anything.

(08:46):
That's great advice.
You know, something I came across in my research was the idea of having bunion surgery on both
feet at the same time.
I have to admit I was kind of thrown off by that.
What are the implications of doing both feet at once?
It's definitely possible to do both feet at the same time, but it's not for everyone.
Surgery is way tougher when you're dealing with two surgical sites instead of just one.

(09:09):
You'll need more help getting around and doing everyday things.
I can imagine trying to handle crushes with two bandaged feet yikes.
It's definitely a lot to deal with.
It might seem easier to just get it over with all at once, but most surgeons recommend doing
the surgeries one foot at a time.
That way you've got one good foot to help you while the other one is healing.
So it's not a strict rule, but it's something to talk about with your surgeon and really

(09:31):
weigh the pros and cons.
Exactly.
It's a personal decision based on your own situation.
Some people, especially those who are very active, might not like the idea of two separate
recovery periods.
But for others, the convenience of having one surgery and one recovery might be worth the
extra challenge.
This has been super insightful.

(09:51):
But before we wrap things up, I realized we haven't really talked about how to choose
the right surgeon.
It's not like you could just pick a random name out of a hat.
To write about that, finding the right surgeon is a huge deal.
It can make all the difference in your bunion surgery journey.
We should definitely spend some time talking about that.
So we're back and we need to figure out how to find the right surgeon for this whole bunion

(10:13):
surgery thing.
I gotta say, just thinking about picking someone to do surgery on my feet is kind of scary.
Oh yeah.
It's a big decision for sure.
You don't want to rush into it.
You want someone who knows what they're doing, has a lot of experience, and makes you feel
comfortable.
But finding that person, that's the tricky part.
Exactly.
It's so much to think about.
It's not like you can just pick the surgeon with the fanciest degree and call it a day.

(10:35):
What are some practical things people can do to narrow down their options?
Well, I always tell people to start by asking around.
Talk to your regular doctor friends, family, anyone you know who's had foot surgery.
You can also check out online reviews, but take those with a grain of salt.
People are more likely to leave a review if they had a really good or really bad experience,
not something in the middle.

(10:56):
So basically, do your research, gather info from different places, and then really think
it through.
Exactly.
Once you have a few names in mind, set up consultations with each surgeon, it's a chance
to get a sense of their personality, how they approach things, and whether you feel like
you can trust them.
Those consultations seem pretty crucial.
What should people be looking for or asking during those meetings?

(11:19):
Pay attention to how the surgeon talks to you.
Do they actually listen to your concerns?
Do they explain things in a way that makes sense and answer all your questions?
Do they seem rushed or like they don't care?
Your gut feeling is important here.
It's all about finding someone you trust and feel good about.
After all, they're going to be operating on your feet.
Exactly.
And don't be shy about asking specific questions about their experience during the consultation.

(11:42):
How many bunion surgeries have they done?
Are they comfortable with different techniques?
Do they have any specialties?
So you're not just looking for someone who's done a ton of bunion surgeries, but someone
who really knows the different options and can suggest the best one for you.
Right.
And definitely ask about what happens after surgery.
What do they do for pain management?
How long is recovery expected to take?

(12:03):
Will you need physical therapy?
Knowing what to expect after surgery can really help you feel more prepared and less anxious.
Sounds like those consultations are all about gathering as much info as you can and making
sure the surgeon is the right fit for you, both on a personal level and a professional
level.
You nailed it.
Choosing a surgeon is a big deal, but if you do your research, ask questions and trust

(12:25):
your instincts, you can find someone who will take good care of you and guide you through
this whole process.
This has been so informative.
I honestly had no idea.
Bunion surgery was so complicated.
It's definitely more involved than most people realize, but that's what makes doing a deep
dive like this so interesting.
Right.
It's all about going deeper and really understanding the ins and outs of something.

(12:46):
I couldn't agree more.
For anyone out there who's thinking about bunion surgery, the main takeaway is to do
your homework, ask lots of questions and find a surgeon you feel good about.
With the right planning and guidance, you can take that step towards happier, healthier
feet with confidence.
Well said.
It's all about empowering yourself with knowledge and making informed decisions.

(13:08):
And even though we've covered a lot today, it's just a starting point.
Your own research, talking to healthcare professionals and trusting your gut are all important in
making the right choice for you.
And with that, I think it's time to wrap up our bunion surgery deep dive.
Thanks for joining us and good luck on your journey to happy feet.
Disclaimer, the content provided in this audio is for informational purposes only and should

(13:29):
not be construed as medical advice.
It is not a substitute for professional diagnosis, treatment or consultation with a qualified
healthcare provider.
Always seek the advice of a physician or another qualified health provider with any questions
or concerns regarding a medical condition.
By listening to this audio platform, neither its hosts, guests, nor publishers establish
a doctor-patient relationship, and no liability is assumed for any decisions made based solely
on the information presented.
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