Lapidus Bunionectomy

A Lapidus bunionectomy is a procedure in which the first metatarsal bone is fixated to the medial cuneiform bone with a plate and screws to stabilize and correct a moderate to severe bunion.  The procedure involves removing a small wedge of bone at the base of the metatarsal to allow for reduction of the bunion.  Fusing the joint at the base of the metatarsal helps prevent any possible return of the deformity.  


What to expect with your surgery

The day of the surgery

On the day of the surgery,  your podiatric surgeon will visit with you and answer any additional questions you may have.  You will also meet with the anesthesiologist to discuss what type of anesthesia you will have for the surgery.  A nurse will typically start an IV so the anesthesiologist can administer any necessary medication during the procedure.  If this is the only procedure being done on your foot, the surgery takes approximately 1 hour.  Your doctor will numb your foot after the surgery and will give you a prescription for pain medication.   You will also be given detailed instructions on how to care for your foot.

Week 1

Most of the pain and inflammation from the surgery will be during week 1.  It is very important to remain non-weight bearing on your surgery foot at all times and to use your crutches or Rollabout scooter whenever up moving.  You should elevate and rest your foot as much as possible.  You will leave your bandages on your foot and you should not get your foot wet.  You should always wear your surgical boot when up moving.  You may remove this during times when you are sitting.  When you return to the office for your first appointment, your doctor will take x-rays and change the dressing.  Sutures are not typically taken out at this point.

Week 2

There is usually less pain and inflammation during this week.  You will continue to be non-weight bearing on the surgical foot.  You will wear your surgical boot and keep your foot dry.  Activity may generally be increased slightly depending on how much inflammation is present.  At the second week appointment, your doctor will usually take out your sutures.  You may be able to get the foot wet at this point as long as you can do so without bearing weight on the surgical foot.

Week 2-4

You will continue to be non-weight bearing during this time.  You doctor will fit you with an ace wrap to help control swelling.

Week 4

Your doctor will usually take an x-ray at this time to ensure that the bone is healing normally.  If things are progressing as expected, you may be able to start to bear some weight on your foot with the surgical boot.  Bone healing will continue throughout the next month.

Week 6-7

Your doctor will likely take another x-ray to assess bone healing.  If enough healing has occurred and there is minimal swelling, you may be able to start walking with a lace-up shoe.

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