Many people want to know what the whole process is of doing bunion surgery and I am going to walk you through the different steps of the bunion surgery. When you come into the operating room first you are going to have a tourniquet that is going to be placed around your leg and this is going to reduce the blood flow during the course of the surgery so that things can be seen better. Your incision is going to go right on the top of your big toe joint or to the side of the toe joint depending on what your surgeon wants to do. This incision is made through the skin and it goes down to the level we call the capsule of the joint. Once you are down to the level of the capsule you need to stop the bleeding of any of the blood vessels there and then open up the area using something called a retractor. Once the area is opened up you can make an incision in the capsule. We tend to do something called an inverted L incision of the capsule. This is just the way that we cut so that we can gain access to the bump on the side of the first metatarsal head. That is the big bump that most people notice when they have a bunion. Once we free up all that skin, we can remove the bump, and then we can go to the place between the first and second bones and free up a tendon there called the conjoined tendon of the adductor hallucis. Once we free that up with a scalpel, we are able to do a cut into the head of the bone. We do a V-cut, which is the most common. This is cut straight through to allow for the head of the bone to go down and shorten a little bit based on your anatomy. Once this is done we can shift over the head of the bone so there is a little bit of a ledge on the side where the bump used to be and that allows for correction of the space between the first and second bone and also replaces the sesamoid bones underneath the head of the bone. Once this is done we put a screw in the area to hold it in place and we remove that remaining ledge that was there. The area is flushed with a lot of sterile water and stitches are used to sew up the capsule after removing a little piece of it to help readjust for the new position of the toe, and then we stitch up the skin with some other types of stitches that can hide underneath the skin. A dressing is placed on the wound usually with some iodine to serve as a splint, and then we put a different type of a wraparound there to hold it in the correct position. So these are the steps for doing bunion surgery.
PS. If you found this helpful here is some more information about bunions.