Selecting a Procedure

Why Are There So Many Bunion Removal Techniques?

In medical literature, there are more than 100 documented ways to perform bunion removal, more than for any other part of the body. Over the years, surgeons have continued refining their approach because outcomes and recovery from earlier techniques have not always been satisfactory. A 2024 systematic review in Archives of Orthopaedic and Trauma Surgery confirms this: "more than one hundred surgical techniques are described" for hallux valgus correction, spanning distal, diaphyseal, and proximal osteotomies as well as joint fusion.

Dr. Moy's procedure is directed toward restoring normal foot function with a virtually pain-free recovery, without the bunion recurring. See the Moy Approach and why bunions return for more on what that correction involves and how it's protected during healing.

• The procedure is performed at the bunion site itself: repositioning the bone and reducing the deforming forces that caused the bunion.
• Internal fixation (a screw) compresses and holds the bone securely, allowing it to heal rapidly and providing stable support for the surgical area. Because of the procedure's stability and minimized pain, patients are able to walk immediately.
• Patients should ask careful questions before agreeing to surgery near the mid-arch of the foot (lapidus or base-wedge procedures). These procedures carry significant inherent risks and complications and generally require 6 to 8 weeks of non-weight-bearing on that area.
• Tightrope or IM banding is not a bunion procedure on its own: it is an adjunctive step that may be added to a bunion procedure when indicated.

Planning the Correction

How much bone to remove and where the metatarsal head should end up is not guesswork. Dr. Moy uses a preoperative radiographic method called the Moy Dorsal Wedge Calculation to estimate the amount of dorsal bone that should be removed during the osteotomy, based on the anticipated final position of the metatarsal head rather than an arbitrary wedge size. See the full definition for how the calculation works.