The Moy Approach

The operation is planned for the individual foot and directed toward restoring the entire first metatarsophalangeal joint as a functional unit, not just removing the visible bump.

"The great toe should simply want to stay home, in its normal anatomical position."

Correcting the Cause, Not Just the Appearance

The visible bump is only one part of the deformity. A durable correction must address the first metatarsal, great toe, sesamoids, tendons, ligaments, joint capsule, and weight-bearing relationship of the forefoot.

The first metatarsal is repositioned sufficiently to restore the integrity of the joint apparatus. The sesamoid complex is brought back beneath the metatarsal head. Tendon and soft-tissue forces are balanced so the great toe rests naturally rather than being forcibly held straight.

Preserving the Joint Whenever Possible

The great toe plays a critical role in walking, balance, propulsion, exercise, and athletic activity. Dr. Moy's goal is to preserve and restore the natural joint whenever it can reasonably be reconstructed.

When stiffness, bone spurs, or early arthritic changes are present, treatment may include decompression, removal of obstructing bone, restoration of joint space, treatment of damaged areas, and preservation of as much motion as possible.

Refining the Bone and Soft-Tissue Contour

After the bony prominence is corrected, thickened scarred capsular tissue may still leave the inner side of the joint looking or feeling prominent. Dr. Moy reduces excess and abnormally thickened capsule so the soft-tissue contour more closely resembles a normal foot before the capsule is repaired.

Precise Tissue Handling

Postoperative discomfort is influenced by more than incision length. Tissue handling, bone preparation, nerve and blood-vessel protection, fixation, removal of debris, and soft-tissue balance all affect the recovery experience.

Dr. Moy emphasizes careful dissection, preservation of neurovascular structures, stable fixation, smooth bone contours, complete removal of loose debris, and repeated assessment of alignment and motion before the operation is concluded.

Immediate Protected Walking

Most patients are placed in a protective walking boot and permitted to bear weight immediately after surgery. Early protected mobility helps patients remain independent while the correction heals. It does not mean unlimited walking; activity must still be carefully controlled.

No Routine Narcotic Pain Medication

Dr. Moy has not routinely prescribed narcotic pain medication following bunion surgery for approximately three decades. When medication is desired, a short course of prescription anti-inflammatory medication or an appropriate nonprescription medication may be sufficient, depending on the patient's medical history and instructions.

Experience Supported by Visible Evidence

A surgical philosophy should be supported by results that patients can examine. Our patient evidence library presents written evaluations, patient videos, before-and-after photographs, weight-bearing X-rays, walking milestones, range-of-motion demonstrations, revision cases, and long-term follow-up.