Woman's feet bright pink toenail polish

When do I need a Lapidus Bunionectomy?

A bunion is a foot condition that causes a bony prominence, or bump, on the inside of the foot at the big toe joint. Depending on a patient’s overall health, symptoms, and bunion severity, bunions may require bunion surgery such as a Lapidus Bunionectomy procedure.

A bunion occurs when the big toe begins to lean toward the second toe. Bunions may show up in a variety of sizes, from small to severe. The biggest misconception about bunions is that they are the result of an overgrowth of bone.  While that may be true in a few cases, bunions usually happen because the big toe joint has dislocated and is bulging against the skin. 

In some cases, the big toe may push against the second toe, which can result in pain and a hammer toe. Left untreated, a bunion can progress into a severe, disfiguring foot deformity.

What is a Lapidus Bunionectomy?

The Lapidus Bunionectomy is a type of corrective bunion surgery that involves restoring the natural position of the big toe joint. In a lapidus procedure, the surgeon will correct the structure of the foot by restoring the poorly aligned metatarsal back to its proper position.

The relocation of the metatarsal is performed using a bone mending procedure on two bones at the instep. Those bones are often too flexible, and can cause the bunion to form in the first place.

Because even the largest bunions can be repaired using the minimally invasive Bunionplasty® procedure, Dr. Blitz and his peers have largely abandoned Lapidus surgeries.

Young woman suffering with bunions

What is the Lapidus Bunionectomy recovery time?

In healthy patients who have a lapidus procedure, it typically takes six weeks for the bones to heal. Patients generally return to their normal activities and shoes between six weeks and three months after lapidus surgery. Factors that may prolong healing include age, smoking, poor nutrition, and some medical problems.

Woman stretching on a track

Is the Bunionplasty® procedure the same as Lapidus surgery?

While Lapidus procedures were once considered the standard of care for bunion correction, the Bunionplasty® 360 Bunion Repair™ procedure, created by Dr. Blitz and refined over nearly two decades of surgical practice, is a significant advancement over traditional methods. By avoiding midfoot fusion and using a combination of patented technology and patent-pending techniques, the Bunionplasty® procedure allows a No Casts No Crutches ® walking recovery, and preserves patient mobility.

Woman under local anesthesia about to enter surgery

What anesthesia is needed for a Lapidus procedure?

Lapidus surgery may be performed under a local, regional, spinal or general anesthetic. A Lapidus procedure is usually an outpatient surgery, meaning patients can go home the same day. 

The most common approach to anesthesia for Lapidus surgery includes local and regional blocks, with monitored anesthesia care. This means that the foot will be numbed with an anesthetic, and an anesthesiologist will provide intravenous medications to relax and provide sedation (often referred to as “twilight”). Patients will not experience or remember their surgery.

Dr. Blitz operating on a patient's foot

Will I have hardware in my foot after a Lapidus Bunionectomy?

Inserting surgical hardware for “fixation” is a necessary part of Lapidus Bunionectomy. The purpose of the fixation is to stabilize the bone while the bones heal into a solid structure. Common lapidus surgery hardware involves screws and plates. The hardware may be made of surgical stainless steel or titanium.

Historically, Dr. Blitz performed the Lapidus bunionectomy using the patented titanium implant he developed in conjunction with a leading orthopedic device manufacturer. This product, known as the Contours Lapidus Plating System, is still used by Lapidus surgeons because of its unique features, innovative design, and ability to get patients moving faster than after other Lapidus procedures.

Surgically hardware can remain in the foot permanently. Some Lapidus bunionectomy patients choose to have the hardware removed if it is irritating the skin from underneath, or simply because they no longer want it there. Dr. Blitz’s innovative Lapidus plate was designed to avoid irritating the foot, and when it is used, hardware removal is extremely uncommon.

Dr. Blitz in surgery performing Lapidus Bunionectomy

What are the risks of the Lapidus surgery procedure?

Like all surgeries, there are general risks associated with bunion surgery and the use of anesthesia. Complications may occur and are not necessarily the fault of the patient or the surgeon, but it’s important for patients to understand what those risks are. 

Bunion surgery complications may include, but are not limited to: infection, pain (temporary or permanent), swelling, hematoma, bleeding, blood clot, poor wound healing, incision breakdown, poor bone healing (delayed union, nonunion), malunion, nerve injury, disability, recurrence, hallux varus, metatarsalgia, unsightly scar, stiffness, shortened big toe during bunion surgery, weakness in big toe, toe drift after bunion surgery, hardware problems, need for revisional surgery, and/or catastrophic loss.

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