Silver bunionectomy:
Removal of medial prominence – “bumpectomy”. Commonly used in conjunction with other procedures (osteotomies). Only used as isolated procedure if large exostosis is present and IM <10°.
Indicated when “bump” pain is the presenting problem; range of motion should be adequate and no crepitus. Does not affect hallux position (patient should be aware of this pre-operatively).
Procedure:
• 5cm incision centred over eminence
• Dissect to identify dorsomedial cutaneous nerve
• L-shaped capsulotomy
• Expose medial eminences resected with microsaggital san blade- also do adductor tenotomy and lateral capsule release
Post op- compression dressing; stitches removed at 2 weeks; passive extension exercises started; stiff soled post op shoe for 4 weeks; sport at 8 weeks
Recurrence can be common, as pathomechanics not addressed (can be combined with Akin osteotomy for better result – especially in the young and active)
Other Bunion Surgery Procedures:
| Capsule/Tendon Balance Procedures | Hallux Procedures | Distal Metatarsal Procedures (DMO) | Neck Procedures | Shaft Procedures |
| Silver | Akin | Austin | Peabody | Scarf |
| McBride | Keller | Chevron | Mitchell | Mau |
| Mayo | Youngswick | Hohmann | Kalish | |
| McKeever | Reverdin | Wilson | Lambrinudi | |
| Watermann | DRATO | Vogler | ||
| Derotational abductory transpositional osteotomy (DRATO) | Ludloff | |||
| Stone | Simmonds-Menelaus | |||
| Volgar/Off-set V osteotomy | ||||
| Base Procedures | Capsulotomies | |||
| Lapidus | Washington monument | |||
| Proximal Austin | Lenticular | |||
| Oblique base wedge osteotomy (Juvara) | Inverted L | |||
| Cresentric: |
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