A bunion is an alignment problem with the first toe, called the Hallux or great toe, and the foot.  There are five long bones in the forefoot called metatarsals that function with the five toes. The bones in the toes are called phalanges. The great toe joint is called the first metatarsal- phalangeal joint.  In the normal foot the five metatarsals are close to one another and almost parallel in their position.  In the most common bunion deformity the first metatarsal bone begins to drift away from the other metatarsals, causing the forefoot to become wider. The webbing between the second toe and the first toe is farther away from the first metatarsal than is the great toe joint.  As a consequence, as the first metatarsal moves away from the other metatarsals, the Hallux leans or moves towards, against, under or over the second toe. The farther the first metatarsal drifts away from the second metatarsal the more the Hallux will lean towards the other toes.  Wearing wider shoes only allows the bunion to get worst.

Surgical repair is designed to re-establish the normal anatomical alignment between the metatarsals and their corresponding toes.  Bunion deformities are grouped as: mild, moderate, severe, and arthritic.  Multiple surgical procedures exist for each level of deformity to achieve anatomical alignment.

The BUNION SLIDE is a favorite procedure by Dr. Forni to correct mild, moderate and arthritic bunion deformities.  A small, cosmetic incision is made on the side of the foot, out of direct sight.  A simple directional osteotomy, bone incision, is made near the anatomical neck of the first metatarsal, well behind the first metatarsal- phalangeal joint.  After the osteotomy is completed,  the entire joint is slid back into the normal anatomical position and stabilized with standard internal fixation.  This simple procedure allows the metatarsal bone to be: lengthened, shortened, elevated, lowered, or moved closer to the other metatarsals. In most cases, a combination of directions is used to slide the great toe joint into the best functioning anatomical position.  When the osteotomy site is stable and the surgical bandage offloads the weight to the surgical site, the patient is allowed to walk.