Nearly 100 bunionectomy procedures have been described in surgery literature. This variety exists because surgeons take into account the severity of the deformity, the quality of the involved joints, the quality of the bone, the age of the patient, and many other factors. While some of these procedures have fallen out of favor due to new technology and discoveries in surgical techniques, one procedure known as the Lapidus bunionectomy has withstood the test of time.
Bunion correction is more nuanced than simply removing the “bump” from the great toe. A bunion is a deformity that can occur in all three planes of the human body and often involves the 1st metatarsal bone splaying away from the 2nd metatarsal bone. Therefore, correction often involves creating a bone cut in the first metatarsal bone, shifting it back into place, and inserting a screw to maintain the newly corrected position. When the deformity is more severe and the 1st metatarsal is splayed far from the 2nd metatarsal, the correction is achieved more towards the middle of the foot to get a better lever arm for correction. In these severe cases, or in individuals who have laxity of the midfoot, the Lapidus bunionectomy is the procedure of choice.
The Lapidus bunionectomy involves fusing the 1st metatarsal bone to its neighboring bone of the midfoot known as the cuneiform. By fusing this joint farther back on the foot, a higher level of correction can be achieved for these severe cases. Because this fusion occurs at the origin of the deformity, patients who undergo this procedure have the lowest recurrence rates of their bunion deformities. Traditionally, the correction and fusion were maintained by wires or screws. Because these implants are less stable, patients would have to be placed in a cast for up to 8 weeks then slowly transitioned back to sneakers. However, with the advent of newerimplants and techniques, patients no longer require casts and may be walking on their foot within weeks of the surgery!
The doctors of Advanced Podiatry have much experience in performing the Lapidus bunionectomy. We carefully select patients who are the right candidates for this more technical type of bunionectomy, and our results speak for themselves!