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Bunion With Metatarsus Adductus

Bunion

• Hereditary condition 

• Deviation of the first metatarsal and big toe over time due to the forces of walking 

• Extremely common 

• 36% incidence 

• Shoes cause irritation and pain, but do not cause the bunion 

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Approximately 29% of people with bunions have a second deformity called Metatarsus Adductus (MTA) 

  • The angle of the second and third metatarsal blocks correction 

  • The second and third metatarsals need to be moved out of the way (lined up to where they should be) to make room to correct the bunion 

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Lapiplasty® and Adductoplasty® 

We utilize the same 3D principles, instrumentation and plating to achieve anatomic normalization of the foot structure. 

After correction the foot is narrower, functions better and the result is long-lasting. 

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We expect a wide range of activity after correction of bunions with Lapiplasty and Adductoplasty 

  • Walking without restrictions 

  • Running 

  • Most forms of exercise 

  • No limitations for work 

  • Minimal to no shoe limitations 

What are the results after Lapiplasty ®? 

98% of patients healed after bunion correction with fusion and biplanar plating 

Journal of Foot & Ankle Surgery, 2018 

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98.4% of patients healed and only a 3% recurrence after Lapiplasty® 

Foot & Ankle International, 2019 

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99% of patients healed and only a 1% recurrence after Lapiplasty® 

Journal of Foot & Ankle Surgery, 2022 

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95% of patients functioned normally and had a 98% healing rate after Lapiplasty big toe joint fusions and Lapiplasty TMT and big toe joint fusions (‘Double’) combined 

Journal of Foot & Ankle Surgery 2023, 2024 

What to expect with Lapiplasty® at Foot and Ankle Center of Iowa 

  • An outpatient procedure lasting about 1.5 hours 

  • Usually done with general anesthesia 

  • We do just one foot at a time 

  • The second side can be corrected after 4 months if needed 

  • Pain is usually minimal to moderate and is controlled with a specific regimen of medications and nerve block 

  • Ability to do ankle joint range of motion almost immediately after surgery 

  • Approximately 6 weeks in a walking boot with light activity 

  • Walking limited to 5-10 minutes each hour at first and progressing over that time to up to 15 minutes each hour 

  • Return to heavier activity and sports after 3-4 months 

  • As with all medical procedures results and recovery timing can vary from person to person 

Possible issues following bone surgery 

  • Swelling will be present for several weeks and could last several months 

  • Scars can take up to 1-1.5 years to fade 

  • There can be some numbness along the scars 

  • Infection (<2% chance) 

  • Need to remove plates and screws (5-10% chance) 

  • Failure of bones to heal (<2% chance) 

  • Recurrence of the original deformity (1-3% chance) 

  • Need for further surgery (rare) 

What else do we do to optimize your outcome with surgery at Foot and Ankle Center of Iowa? 

  • Educate and inform you on what to expect at each stage of the process from pre-surgery through all stages of recovery 

  • Optimize bone health 

  • Utilize a specific multi-modal pain management protocol to minimize pain and limit the need for narcotics 

  • Minimize swelling and pain with utilization of Incrediwear® compression devices and early active range of motion 

  • NO CASTING EVER so that we minimize atrophy and loss of function 

  • Early showering to be able to clean the foot and desensitize the nerves 

  • Early protected walking in a boot (~4 days) which stimulates bone healing and decreases swelling and loss of function 

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