Hallux Valgus Correction

Hallux valgus correction refers to a group of surgeries designed to realign the big toe, reduce the bunion prominence, and restore more normal foot mechanics. Surgery is considered when pain is persistent, interferes with daily activities, and does not improve with conservative measures such as shoe modification, insoles, or pain medication ⁽²⁾.

There is no single procedure suitable for all patients; the choice depends on multiple factors such as the severity of the deformity, the alignment of the bones, the presence of arthritis, and the patient’s age and activity level among others. The most common surgical procedures fall within three categories:
‍
● Osteotomy (bone realignment): cutting and repositioning the bone to correct the alignment while preserving the joint.
● Arthrodesis (joint fusion): permanently fusing a joint to correct severe deformity or instability.
● Arthroplasty (joint resection): removing part of the joint to relieve pain, typically reserved for elderly or less physically active patients.
‍
The procedure is performed through incisions over the big toe joint, and fixation devices such as screws may be used to maintain correction while the bone heals. Many patients are allowed to bear weight immediately after surgery while wearing a specialized postoperative shoe.Your surgeon may recommend hip arthroscopy if you experience persistent hip pain, restricted motion, or mechanical symptoms such as catching or locking that do not respond to non-surgical treatments.

Hallux valgus surgery is generally effective, with good outcomes reported in the majority of patients. However, as with any surgery, complications can occur; across many techniques, the overall complication rate is approximately 18.5% ⁽¹⁾; the most common ones consist of:Hip arthroscopy is generally considered a safe procedure, but like all surgeries, it carries risks. As expected from a minimally invasive procedure, the risks of a complication arising from a hip arthroscopy are quite low (0.58%), although still present, and mainly consist of:
‍
● Metatarsalgia: pain under the ball of the foot caused by increased pressure on the smaller metatarsal bones.
● Recurrent deformity: gradual return of the bunion or big toe misalignment after surgery.
● Joint stiffness: reduced range of motion of the big toe joint following healing.
● Wound-healing disorders: delayed or impaired healing of the surgical incision, sometimes with redness or drainage.
● Hallux varus: overcorrection of the big toe causing it to deviate inward, away from the smaller toes. (1,4)
‍
More serious complications, such as impaired blood supply to the bone, nonunion after fusion, or infection, are less common but possible. General surgical risks related to anesthesia, such as blood clots or cardiopulmonary complications, are rare but will be discussed with you before surgery if applicable.
‍

Before surgery, your surgeon will examine your foot and obtain X-rays to assess bone alignment and the presence of arthritis. These findings help determine the most appropriate surgical technique.
‍
Hallux valgus correction is usually performed under regional anesthesia (e.g. nerve block), or alternatively, under general anesthesia ⁽⁵⁾. After surgery, your foot will be carefully bandaged to maintain alignment, and any residual pain may be managed using a combination of medications such as acetaminophen or anti-inflammatory drugs.

Most patients go home the same day or shortly after surgery. You are typically allowed to walk immediately while wearing a specialized postoperative shoe. Keeping the foot elevated during the first week is important to reduce swelling and promote healing ^(6).
‍
Bandages usually remain in place for several weeks, and sutures may usually be removed after about two weeks. Gradual return to normal footwear usually occurs over a month and a half, and return to unrestricted activities usually occurs over 4 months ⁽⁷⁾, while high-impact activities should be avoided until healing is complete. Follow-up visits with your surgeon ensure proper recovery and maintenance of the correction.

Ettinger, S., Spindler, F. T., Marschall, U., Polzer, H., Stukenborg-Colsman, C., †, & Baumbach, S. F. (2025). Hallux Valgus: Prevalence and Treatment Options. Deutsches Arzteblatt international, 122(11), 308–314. https://doi.org/10.3238/arztebl.m2025.0068

Wülker, N., & Mittag, F. (2012). The treatment of hallux valgus. Deutsches Arzteblatt international, 109(49), 857–868. https://doi.org/10.3238/arztebl.2012.0857

Dias, C. G., Godoy-Santos, A. L., Ferrari, J., Ferretti, M., & Lenza, M. (2024). Surgical interventions for treating hallux valgus and bunions. The Cochrane database of systematic reviews, 7(7), CD013726. https://doi.org/10.1002/14651858.CD013726.pub2

Schuh, R., Willegger, M., Holinka, J., Ristl, R., Windhager, R., & Wanivenhaus, A. H. (2013). Angular correction and complications of proximal first metatarsal osteotomies for hallux valgus deformity. International orthopaedics, 37(9), 1771–1780. https://doi.org/10.1007/s00264-013-2012-4

Sharrow, C. M., & Elmore, B. (2022). Anesthesia for the Patient Undergoing Foot and Ankle Surgery. Clinics in sports medicine, 41(2), 263–280. https://doi.org/10.1016/j.csm.2021.11.010

Attar, F., Selvan, D., Machin, D., Shariff, R., & Geary, N. P. (2007). Perioperative changes in the microcirculation in feet after foot and ankle surgery. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 46(4), 238–241. https://doi.org/10.1053/j.jfas.2007.03.003

Liu, G. T., Chhabra, A., Dayton, M. J., Dayton, P. D., Duke, W. J., Farber, D. C., Hatch, D. J., Kile, D. A., Koay, J., McAleer, J. P., Raissi, A., Raspovic, K. M., Santrock, R. D., Taylor, R. P., VanPelt, M. D., & Wukich, D. K. (2022). One- and Two-Year Analysis of a Five-Year Prospective Multicenter Study Assessing Radiographic and Patient-Reported Outcomes Following Triplanar First Tarsometatarsal Arthrodesis With Early Weightbearing for Symptomatic Hallux Valgus. The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 61(6), 1308–1316. https://doi.org/10.1053/j.jfas.2022.04.008