What is a Lapidus Bunionectomy?

Who is an ideal candidate for this treatment?

  • A severe deformity or a high degree of “intermetatarsal angle” (the gap between your bones).
  • Bunions recur after a previous bunion surgery has failed.
  • You have instability and hypermobility (excessive looseness) in the midfoot at the base of the first metatarsal.
  • You are experiencing significant pain that limits walking or daily activity.
  • You suffer from flat feet, fallen arches, or alignment issues that contribute to the bunion formation.

Is your bunion coming back, or is it worse than ever? The “bump” could be a symptom of a loose joint further up the foot. We offer a solution that doesn’t just mask the problem but fixes it at the source. Book Now

Do I need help? Possible Signs

The signs for a Lapidus candidate are often more “structural” than a standard bunion.

  • Worsening bunion deformity over time can be accompanied by significant swelling, redness, or irritation.
  • The “Splaying” Effect occurs when your forefoot appears to be getting wider.
  • Arch Pain radiating from deep in the arch of your foot and/or pain not just at the base of the big toe.
  • Big toe drifting significantly toward the second toe, with a visible rotation of the big toe nail, which is facing inward.
  • A feeling of instability, like your foot “gives way” or you can’t get a solid push-off when walking.

What to expect before surgery?

  • Compassionate Care
  • Thorough Examination & Personalized Treatment Plan
  • Patient’s Goals Discussed & Straight Answers to Difficult Questions
  • Support You Can Count On

Non-Surgical options

  • Footwear changes, including wider and more supportive footwear. This can include custom functional orthotics, including inserts, padding, and/or bunion splints) control the hypermobility of the first metatarsal and improve alignment.
  • Midfoot sleeves to brace and provide compression to the unstable joint.
  • Activity modification through avoiding high-impact activities that strain the midfoot.
  • Anti-inflammatory medications to manage general inflammation.

Definition of Treatments:

The Lapidus is often considered the “heavy lifter” of bunion corrections. The Lapidus Bunionectomy attacks the “root cause” of the problem by addressing instability at the base of the first metatarsal. Instead of cutting the bone near the toe, the surgeon addresses the tarsometatarsal (TMT) joint in the middle of the foot. The joint at the base of the first metatarsal is realigned, the cartilage is removed, and it is fused (arthrodesis) to eliminate the deformity. Medical-grade plates and screws are used to stabilize the fusion. Unlike other procedures, the “locking” of this joint, the first metatarsal, is permanently straightened. Because the joint no longer moves, it is especially effective for more severe cases, as the bunion cannot physically return.

FAQs

Mobility

There will be a loss of movement at the base of the foot (the TMT joint), but this joint was already too loose. You will still have full movement of your big toe joint, allowing you to walk, run, and wear heels normally. Progression to walking occurs gradually with guidance and physical therapy.

Risk of Recurrence

This procedure has the lowest recurrence rate when compared to other bunion procedures because it eliminates the instability that caused the bunion in the first place.

Cosmetic Consideration

The Lapidus significantly improves foot alignment, which provides a dramatic narrowing of the foot by restoring it to the natural “V-shape” of the foot structure, making it much easier to fit into standard-width footwear.

Recovery Timeline

  • 0-2 Weeks: Non-weight bearing (crutches or a knee scooter) to allow the fusion to begin.
  • 2-6 Weeks: Protected weight-bearing and significant use of walking boot (varies by case, surgeon, and hardware used).
  • 8-12 Weeks: Gradual increase in activity and transition into athletic shoes.
  • 3–4 Months: Return to most normal
  • 4–6 Months: Full return to high-impact sports.

Considerations/Risks

Typical
  • Swelling and stiffness, and due to the midfoot location, swelling can persist longer than in other surgeries.
  • Pain and risk of infection are the greatest risks during the early stages of recovery.
  • Nerve irritation or numbness
  • Strict Non-Weight Bearing: If you step on it too early, you risk breaking the hardware or preventing the fusion.
Atypical
  • Hardware Sensitivity or irritation to the plates and screws used in surgery can sometimes be felt under the skin in thin patients, requiring removal.
  • In only 3–5% of cases, the bones fail to fuse (non-union) and do not heal in the correct position (malunion), which often requires a second procedure.
  • Nerve Entrapment: The dorsal cutaneous nerve sits near the incision; irritation can cause tingling on the top of the foot.
  • Shortening: The first metatarsal may be slightly shorter after surgery, which rarely causes a “transfer” of pressure to the second toe.

Why Choose Lone Star?

  • Board-Certified Orthopaedic Surgeons with Exceptional Expertise
  • Advanced Surgical Techniques and Technology
  • Reputation for Patient-Centered Care and Results
  • Collaborative Care Team Approach

Disclaimers:

  • The information provided on www.lonestar-ortho.net is intended for general informational and educational purposes only. The content on this website is presented in summary form, general in nature, and should not be considered medical advice, diagnosis, or treatment recommendations.

  • The materials and information provided on this website are not intended to replace professional medical advice, care, or consultation with a qualified healthcare provider. Always seek the advice of your physician or another qualified healthcare professional regarding any medical condition, treatment option, or health concern.

  • Do not ignore professional medical advice or delay seeking care because of something you read on this website. If you think you may have a medical emergency, call 911 or seek immediate medical attention.

Book Your Appointment Today

Temporary fixes do not resolve the issue. If you live with worsening bunion pain or instability. We can correct the problem at its source and help you move forward with confidence.