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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 

bunion image
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 

bunions mta
bunions mta
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. 

bunions mta
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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