HomeSurgery guidesBunion correction (osteotomy)
Forefoot surgery

Bunion correction (osteotomy)

Bunion surgery realigns the bones of the big toe to correct the deformity and relieve pain. The exact procedure (Chevron, scarf, Lapidus, or fusion) depends on the severity of the deformity. This guide covers what to expect.

Before surgery
The day of surgery
In hospital
Going home
Recovery week by week

Step 1: Your pre-operative assessment

ℹ️ This appointment takes place 2-4 weeks before surgery. The team will confirm you are fit and prepare you for the operation.

You will meet the nursing and anaesthetic teams. Bloods, ECG, and a medication review will be carried out. Plan your home arrangements, you will need crutches and a special shoe for several weeks.

What will happen at the pre-assessment?

Blood tests and an ECG

Standard pre-operative checks.

Medication review

Blood thinners such as warfarin, apixaban, clopidogrel, or aspirin may need to be paused before surgery.

Anaesthetic discussion

Bunion surgery is usually performed under regional ankle block, often combined with sedation or a light general anaesthetic.

Get the right footwear ready

You will wear a heel-weight-bearing surgical shoe for around 6 weeks. The hospital usually provides this.

Prepare your home

Arrange for someone to help you for the first few days. You will be using crutches initially and will not be able to drive.

The day of surgery

ℹ️ You will be given a specific arrival time. Do not eat or drink (other than clear water up to 2 hours before) from midnight the night before. Bring your medication list and any documents sent by the hospital.

Arrive at the time given

You will be admitted to the ward or day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.

Consent and marking

Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.

Anaesthetic

You will meet the anaesthetist in the anaesthetic room. Once anaesthesia is established, the procedure will begin.

Recovery room

After surgery you will wake in the recovery room where nurses monitor your vital signs until you are stable and comfortable.

In hospital

Most foot and ankle surgery is performed as a day case, meaning you go home the same day. More complex procedures such as ankle replacement or flat foot reconstruction usually require 1-3 nights in hospital. Before discharge, the team will check your pain is controlled, give you wound care instructions, and confirm your follow-up appointment.

Pain control

You will be given oral pain relief before discharge. Take it regularly for the first 48 hours rather than waiting until pain is severe.

Wound check and dressing

A nurse will check the wound before you leave and explain how to keep it clean and dry.

Crutches and weight-bearing instructions

You will be shown how to use crutches and given clear instructions about weight-bearing on your operated foot.

Discharge letter and follow-up

You will receive a letter for your GP and details of your next outpatient appointment, usually at 2 weeks for a wound check.

You must not drive yourself home

Arrange for a family member or friend to collect you. You must not drive after a general anaesthetic or sedation.

Going home

⚠️ Important: Swelling after bunion surgery can persist for 6 months or more. This is normal and not a sign that something is wrong. Recurrence (around 10-15% over 10 years) is more likely if you return to narrow or high-heeled shoes.

Elevate your foot

Keep the foot elevated above the level of your heart for as much of the day as possible during the first 2 weeks. This significantly reduces swelling and helps healing.

Keep the wound clean and dry

Avoid getting the wound wet until it is fully healed, usually 10-14 days. Use a waterproof cover when showering.

Take your pain relief as prescribed

Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, ibuprofen if appropriate) is more effective than taking it only when needed.

Attend your wound check appointment

This is usually 2 weeks after surgery. Sutures or clips will be removed if used.

When to contact the hospital

Seek urgent advice if you develop increasing redness, warmth, swelling, discharge from the wound, calf pain or swelling (possible DVT), shortness of breath, or a temperature above 38°C.

Recovery week by week

Weeks 0-2

Recovery and elevation

Foot kept elevated as much as possible to reduce swelling. Weight-bearing through the heel in surgical shoe is usually permitted.

Week 2

Wound check, stitch removal

Outpatient appointment to check the wound and remove stitches if used.

Weeks 2-6

Surgical shoe, progressive walking

Heel-weight-bearing in surgical shoe. Increasing time on feet, but elevation still important.

Weeks 6-12

Transition to normal shoes

X-rays confirm bone healing. Transition to wide, soft trainers. Gentle physiotherapy if needed.

3-6 months

Return to most activities

Walking comfortably. Most fashion footwear still difficult due to ongoing swelling.

6-12 months

Final settling

Swelling gradually resolves. Return to all desired footwear and activity.

Common questions

Will I need a cast?

No. Most modern bunion surgery uses internal fixation (screws), allowing you to weight-bear through the heel in a surgical shoe straight away.

When can I drive?

For the right foot, typically 6-8 weeks. For the left foot in an automatic car, around 2 weeks if comfortable.

How long off work?

Desk work with elevation: 2-4 weeks. Standing work: 6-12 weeks. Manual or sport-related work: 3-6 months.

Can both feet be done at the same time?

Yes, but mobility is significantly more limited. Most patients prefer to have one foot done at a time.

Common questions

Your questions, answered

Plain-English answers to the things people most often ask, grounded in published guidance. Tap a question to open it.

Your operationWhat happens during bunion surgery?

The bone behind the big toe is cut and realigned, usually held with one or more small screws, and the soft tissues are balanced.

The screws normally stay in and are not felt.

Sources  BOFAS · AAOS OrthoInfo
Your choiceShould I have it done?

Surgery is for bunions causing pain or trouble with footwear, not for appearance alone, and recovery is long.

It is a considered decision rather than a quick correction.

Sources  BOFAS
AnaesthesiaWhat anaesthetic is used?

Often a general or spinal anaesthetic with an ankle or foot block for pain relief.

Many bunion operations are day cases.

Sources  NHS
Getting backWhat is recovery like?

Expect a special post-operative shoe or boot for some weeks, with weight-bearing as advised.

Foot swelling is normal and can take six to twelve months to fully settle.

Sources  AAOS OrthoInfo
Your choiceCan the bunion come back?

Recurrence is possible, more so with larger deformities, and footwear habits afterwards play a part.

Your surgeon chooses the technique to give a durable correction.

Sources  AAOS OrthoInfo · BOFAS
UrgentWhat needs urgent review?

Spreading redness, discharge, a temperature, or a cold or blue toe need prompt help, as does calf or chest symptoms.

Keep the foot elevated to reduce swelling and risk.

Sources  NHS
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