How Bunion Surgeries Compare

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A variety of surgical methods are used to correct bunions. Also referred to as a bunionectomy, most methods re-align the bone leading to the base of the big toe (the first metatarsal) and include repairs to the surrounding tendons and ligaments that may have become too loose or too tight. These soft tissue imbalances push the big toe toward the other toes. Over time, the joint at the base of the big toe protrudes outward and becomes inflamed and painful.

By re-aligning the bone and correcting the soft tissues, pain is relieved, the bunion ‘bump’ is eliminated, and the toe is properly aligned.

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I don’t want a permanent joint fusion in my foot, and I want the smallest possible scar.”

~ Bunion surgery candidate

Surgery Comparison Infographic

Bunion Deformity

Active Bunion Surgery

The Active Bunion surgery is an advanced type of osteotomy, meaning a surgical procedure that corrects bone alignment, that is often combined with soft tissue correction. Here, a small cut is made in the first metatarsal bone, and the bone is shifted as needed on multiple dimensions (up or down, horizontally, and positioned for proper rotation) bringing the bone and joint back into its natural position. The cut is then fixed into place with the CoLink Vallux^® surgical plate. The bone heals like a fracture — and because only one bone is involved, recovery may be faster with fewer complications compared with other surgeries.

Active Bunion represents an evolution in traditional osteotomies because of the advanced plate design and materials, the simplified surgical technique, and multi-dimensional movement correction. Traditional bunion surgeries typically only correct one plane of foot movement.

Traditional, Open Bunionectomy

(Chevron or Austin Osteotomy)

Called ‘open’ because a large incision is made to permit the surgeon to view the entire joint capsule area, the Chevron or Austin osteotomy has the longest history of use. The surgeon may first remove the ‘bump’ or excessive bone from the side of the first metatarsal; then, that bone is cut and shifted into place to straighten the toe joint area. The soft tissues are adjusted, and the cut bone is secured into place with metal screws. This surgery is frequently used for mild to moderate bunions.

Among the biggest differences with the Active Bunion surgery is that the Open Chevron and Austin are NOT minimally invasive, requiring larger incisions and producing more internal scarring, which can cause more stiffness and pain after surgery.

3D Lapidus Procedure

Here the surgeon removes a small wedge of bone at the base of the first metatarsal bone (in the mid-foot, instead of cutting the bone further up, closer to the base of the big toe). Soft tissues are also re-balanced. The cut portion of the bone is then joined together with the medial cuneiform bone using a plate and screws. As the joint heals, it fuses together — a process believed to prevent the bunion from reforming. This surgery is used for extremely severe bunions.

Surgeons usually consider any type of joint fusion to be an end-stage correction reserved for the most severe bunion removal cases, because a fused joint cannot be repaired further. This fusion can lead to future complications because other foot joints may wear down more quickly, requiring another surgery.

The biggest differences between the Lapidus and Active Bunion surgeries are that with 3D Lapidus, the bunion is repaired at the mid-foot, and the joint is fused — requiring longer healing time, possibly restricting how the foot moves, and visibly shortening the length of the big toe. There is added risk that the fusion will fail, requiring more surgery. With the simpler Active Bunion surgery, no joints are fused or changed, and the length of the big toe remains as normal.

More comparisons between surgeries are shown in the table below.

Types of Bunion Procedures table

Types of Bunion Procedures table

Why Choose
Active Bunion?

For a quick overview of all the advantages of this bunion surgery, download our brochure for patients:

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Active Bunion Patient Brochure Cover