Bunion Surgery — When to Do Proximal and Distal Osteotomy

When your bunions have gotten extremely painful or so large you struggle to find shoes, it might be time to consider surgery to remove them. These days, there are a number of minimally invasive bunions removal procedures that permanently get rid of your bunions, with significantly less pain, correction of the three dimensions of deformity and a shorter recovery time. 

Two bunion procedures Dr. Thomas Rambacher, DPM, FACFAS, FAPWCA, performs to remove bunions at Podiatry Hotline Foot & Ankle in Mission Viejo, California, are proximal and distal osteotomy. Discover more about each of these bunion removal surgeries and which is right for you.

Choosing surgery to remove bunions

Bunions, the large, unattractive, and potentially painful deformities that can grow on the outside of your big toe joint, can often be managed nonsurgically. However, in some instances, Dr. Rambacher recommends surgery to remove your bunions.

There are several reasons our podiatrists might recommend bunion surgery. These include:

• Your bunion has caused your toes to move out of alignment, including causing your big, first, or second toe to turn to the side and overlap.

• Your bunions are so large you aren’t able to find shoes that fit your feet.

• You’re in high levels of pain, and more conservative treatment hasn’t resolved it.

Bunions surgery is also an option if you dislike the way your feet look with bunions and would like to improve their appearance.

Bunions surgery options

Often, Dr. Rambacher performs a form of osteotomy surgery when removing your bunions. An osteotomy is a procedure that involves removing the extra bunion bone using surgical cuts.

Dr. Rambacher uses the most minimally invasive measures possible when making these cuts. Two of the osteotomies he often performs are proximal and distal osteotomy.

These are some of the differences between these two surgeries.

Proximal osteotomy

In a proximal osteotomy, Dr. Rambacher makes a surgical cut near the base of your first metatarsal, which is in your midfoot, toward your ankle. Once he makes this initial cut, he pushes or manipulates your bone inward, which corrects your bunions.

This type of surgery is often highly successful on patients with extremely large bunions that have caused your first and second toe to misalign and patients with midfoot spacing issues.

Distal osteotomy

The distal osteotomy is similar to a proximal osteotomy; however, the key difference is where Dr. Rambacher makes the surgical cut, instead of making this cut farther down in your midfoot, they make a v-shaped cut farther up on your foot, closer to your big toe.

The distal osteotomy is often a good option if you have a large bunion, but your other toes and midfoot remain in relatively good alignment.

Which type of bunion surgery should I get?

Dr. Rambacher recommends the best bunion surgery to correct your bunions based on the size of your bunion and the severity of your toe misalignment. Generally speaking, he’s more likely to recommend a proximal osteotomy if your toes are more severely out of alignment or midfoot spacing and arthritis, while he’s more likely to recommend distal osteotomy for a large bunion with limited misalignment in your toes as a whole.

Dr. Rambacher might also recommend other minimally invasive surgical techniques, depending on your unique three dimensional needs.

If your bunions are causing you problems, it might be time to consider surgical repair. To make an appointment for your consultation, contact us by phone or online.