Stephen L Barrett, DPM is no longer affiliated with Barrett Foot and Ankle Centers

US Neuropathy Centers Affiliate


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One of the more common conditions treated by podiatric surgeons is the painful bunion. Patients with this condition will usually complain of pain when wearing certain shoes, especially snug fitting dress shoes, or with physical activity, such as walking or running.moderate bunion Surgical correction is aimed at the specific type and level of the deformity.  The type of surgery must be matched to the level of deformity to assure maximal outcome.  There are many surgical procedures to correct bunion deformities, and Dr. Stephen L. Barrett is highly trained to assure that the selection criteria is thoroughly evaluated. Selection of the most appropriate procedure for each patient requires knowledge of the level of deformity, review of the x-rays and an open discussion of the goals of the surgical procedure. Almost all surgical procedures require cutting and repositioning the first metatarsal or great toe.


Bunion Procedure Information


Hallux Abducto Valgus

The condition is essentially a slow, progressive dislocation of the joint behind the great toe.  As the great toe rotates and moves laterally towards the second toe, the first metatarsal (the bone behind the great toe) shifts in the opposite direction and becomes more pronounced.


What is a Bunion?

A bunion is a deformity which begins as a small prominence at the head of the first metatarsal (the far end of the bone behind the great toe) which progressively grows.  The technical term for a bunion is "hallux valgus" or "hallux abducto valgus."


What causes Bunions?

Bunions may be caused by any one or a combinatino of the following factors:

  • predisposing structural/biomechanical factors
  • mechanical factors - i.e. shoes
  • general ligamentous laxity - loose ligaments
  • inflammatory conditions/arthritis

Bunion Formation


Surgical Treatment
Once fully developed, bunion deformities cannot be "corrected" without surgery.  Bunion surgery is almost always performed as an "outpatient" procedure, under general anesthesia.  The exact type of procedure is determined by a number of factors, including the patient's age, weight, bone quality, and severity of deformity.

Surgical Correction of Mild to Moderate Bunions
The procedure used to correct the majority of bunion deformities is the distal metaphyseal osteotomy (Austin, Chevron, Kalish).

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Surgical Correction of Severe Bunions

Severe bunion deformities require a more extensive surgery to provide a long lasting correction.  The procedure is known as a base wedge osteotomy.


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Surgical Correction of Arthritic Bunions and Joints

Bunions or joints which are arthritic may not be salvageable via the previously discussed procedures and may require an Arthroplasty or Implant Arthroplasty procedure.


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Advantages or the Distal Metaphyseal Osteotomy

  • Easily performed under local anesthesia
  • Permits immediate weight bearing
  • Return to closed shoe gear (i.e. tennis shoes) in 2 weeks
  • Excellent long-term correction




Advantages of the Base Wedge Osteotomy

  • May be performed under local anesthesia
  • Permits long-lasting correction of the most severe deformities
      ** This procedure requires non-weight bearing for 6-8 weeks and may require a cast



Minimally Invasive Bunion Surgery - Image Gallery

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