Understanding Lapidus vs MIS Bunion Surgery: What You Need to Know
Last updated: 2025-11-17
Author: Dr. Emily Harper, DPM (Doctor of Podiatric Medicine)
If you’re looking into bunion correction, two common surgical options are Lapidus and MIS (Minimally Invasive Surgery). Both aim to relieve bunion pain and correct foot deformities, but they differ in technique, recovery, and long-term success. This article explains these differences, helping you make an informed choice for your foot health.
Key Takeaways
- Lapidus surgery fuses foot joints for a strong, lasting correction and lower bunion recurrence.
- MIS surgery uses small cuts and bone reshaping but depends heavily on bone healing and has a higher recurrence risk.
- Lapidus involves a larger incision, while MIS is less invasive with smaller scars.
- Your bunion severity and lifestyle goals influence which surgery suits you best.
- Non-surgical options like orthopedic bunion sleeves can ease pain and support alignment.
- Consult a podiatrist for personalized advice, especially if bunion pain affects daily activities.
What Is a Bunion (Hallux Valgus) and Bunionette (Tailor’s Bunion)?
A bunion (hallux valgus) is a bony bump that forms at the base of the big toe, causing the toe to angle inward toward the second toe. This can cause pain, swelling, and difficulty wearing shoes [1]. A bunionette (tailor’s bunion) is a similar bump on the outside of the foot near the little toe [2]. Both conditions result from joint misalignment and pressure, often worsened by tight or narrow footwear.
Glossary:
- Bunion (hallux valgus): Bony protrusion at the big toe base.
- Bunionette (tailor’s bunion): Bump on the outside of the foot near the little toe.
- Toe spacers: Devices placed between toes to realign them.
- Bunion sleeves: Soft sleeves that cushion and support the bunion area.
- Orthoses: Custom foot supports or braces to correct foot mechanics.
Lapidus vs MIS Surgery: The Basics
What Is Lapidus Surgery?
Lapidus surgery is considered a robust approach to correcting moderate to severe bunions. It involves:
- Making a larger incision to access the joint between the first metatarsal and the cuneiform bone (tarsometatarsal or TMT joint).
- Fusing the TMT joint, and sometimes the metatarsophalangeal (MTP) joint, which stabilizes the foot structure and prevents bunion recurrence [3].
- Fixing bones with plates and screws that provide immediate mechanical stability—no reliance on bone healing alone.
- Adjusting soft tissues (ligaments, tendons) to support realignment.
This surgery is often recommended when the bunion deformity is severe or unstable [4].
What Is MIS (Minimally Invasive Surgery)?
MIS bunion surgery uses small incisions to:
- Perform osteotomies—cutting and repositioning bone segments without fusing joints.
- Use screws or staples to hold the bone halves, relying on natural bone healing to fill the gap.
- Minimize visible scarring and soft tissue trauma.
- Typically does not involve joint fusion, so there is a higher risk that the bunion may recur if bone healing is incomplete [5].
MIS is suited for mild to moderate bunions or patients preferring a less invasive approach.
Symptoms and When to Seek Care
Common bunion symptoms include:
- Pain or tenderness around the big toe joint
- Visible bump on the side of the foot
- Swelling or redness near the joint
- Difficulty wearing tight or narrow shoes
- Changes in foot shape affecting gait
You should see a podiatrist if:
- Pain limits daily activities or walking
- The bunion worsens despite conservative care
- You notice persistent swelling or skin irritation
- You experience numbness or severe discomfort
Early intervention can prevent progression and reduce the need for surgery [6].
Conservative Management Options and Product Use Guidance
Before considering surgery, many patients find relief with conservative treatments:
- Orthopedic bunion sleeves cushion the bunion, reduce pressure, and provide gentle realignment support. For example, the Halluxcare Orthopedic Bunion Pain Relief & Correction Sleeve is highly rated by users for comfort and effectiveness.
- Toe spacers can help separate toes, improving alignment and decreasing friction. Start with short periods and increase wear time gradually [7].
- Foot orthoses (custom insoles) support foot mechanics and reduce stress on the bunion joint.
- Appropriate footwear with a wide toe box, soft materials, and low heels reduces pressure on the bunion.
Fit and Footwear Tips to Support Bunions
Choosing the right shoes is crucial to manage bunion discomfort:
- Look for shoes with a wide toe box to avoid crowding the toes.
- Choose soft, flexible materials like leather or mesh that conform to foot shape.
- Avoid high heels or narrow, pointed toe shoes which increase pressure on the bunion [8].
- Consider shoes with adjustable straps or laces for a customized fit.
Proper footwear can slow bunion progression and improve comfort daily.
Exercises and Daily Routines for Bunions
While exercises won’t correct a bunion deformity, they can relieve stiffness and improve foot function:
- Toe stretches: Gently stretch your big toe away from the others to maintain mobility.
- Foot strengthening: Use towel scrunches or marble pickups to strengthen foot muscles.
- Range-of-motion exercises: Rotate and flex your big toe to reduce stiffness.
- Avoid prolonged standing or activities that worsen pain.
Incorporate these routines daily for best results [9].
Making an Informed Choice: Tips for Patients
- Review peer-reviewed medical literature and guidelines from reputable sources like the American Orthopaedic Foot & Ankle Society (AOFAS) or National Institutes of Health (NIH) [10].
- Discuss all options with your podiatrist, including recovery time and expected outcomes.
- Consider your bunion severity—Lapidus is often better for severe deformities, while MIS may suit milder cases.
- Ask about hardware used and healing timelines to plan your rehabilitation.
- Factor in your lifestyle—active people may prefer the durability of Lapidus despite longer recovery.
How to Use Orthopedic Bunion Sleeves: Routine
- Wear sleeves daily, especially in shoes that might rub your bunion.
- Use them during activities that cause discomfort, such as walking or standing.
- Remove at night to allow skin to breathe.
- Combine with toe spacers or proper footwear for enhanced support.
- Monitor skin for irritation and adjust sleeve fit if needed.
FAQs About Bunions and Surgery
Are toe spacers safe for bunions?
Yes, toe spacers are safe when used properly. They help realign toes and reduce friction. Start with short wear times to avoid discomfort and increase gradually [7].
How long should I wear toe spacers daily?
Begin with 15-30 minutes per day and increase as tolerated. Many people wear them during the day in comfortable shoes for several hours [7].
What is the difference between a bunion and a tailor’s bunion?
A bunion (hallux valgus) affects the big toe joint, while a tailor’s bunion (bunionette) occurs on the outside of the foot near the little toe [1][2].
Do bunion sleeves help with shoe comfort?
Yes, bunion sleeves cushion the bony bump, reduce irritation, and provide gentle support, improving comfort inside shoes [7].
When should I see a podiatrist about my bunion?
If you experience persistent pain, swelling, difficulty walking, or skin changes around the bunion, consult a podiatrist for evaluation [6].
Can I run or play pickleball with a bunion?
You can often continue activities with proper footwear and support, but severe pain or deformity may require medical treatment. Discuss activity goals with your doctor [4].
Recommended Halluxcare.com Bunion Products for Relief and Support
If you're looking for relief from bunion pain, consider using the Orthopedic Bunion Pain Relief & Correction Sleeve, which provides support and helps to alleviate discomfort.
For additional protection, the Tailor's Bunion Bunionette Pain Relief Protection Sleeves are designed to offer comfort and protection for bunionette pain.
To nourish and soothe the skin around bunions, as well as to promote healthy hair, consider the Jamaica Black Castor Oil Soothing Oil. Known for its moisturizing and anti-inflammatory properties, it helps alleviate discomfort around bunions and supports hair growth and scalp health.
Sources
- MedlinePlus. Bunion. https://medlineplus.gov/ency/article/001147.htm
- American Podiatric Medical Association (APMA). Tailor's Bunion. https://www.apma.org/Patients/FootHealth.cfm?ItemNumber=984
- American Orthopaedic Foot & Ankle Society (AOFAS). Lapidus Procedure. https://www.aofas.org/footcaremd/treatments/pages/lapidus-procedure.aspx
- National Institutes of Health (NIH). Bunion Surgery Outcomes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMCxxxxxxx/
- Cochrane Review. Minimally Invasive Bunion Surgery. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CDxxxxxxx.pub2/full
- National Health Service (NHS). When to see a doctor about bunions. https://www.nhs.uk/conditions/bunions/
- Journal of Foot and Ankle