Learn about Tightrope Bunion Surgery

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Bunion Overview

Bunions, medically known as hallux vaigus, occur when your big toe points toward your other toes. This results in a painful bump or knot on the edge of the big toe, near the joint. The bump is actually new bone growth or a fluid-filled sac that develops as a result of pressure on the area. Although bunions tend to run in families, they are often caused by improperly fitting shoes or high heels. If left untreated, bunions will worsen over time.

Tightrope Bunion Surgery

To perform tightrope surgery for bunions, four small holes—about 1.1 millimeters in diameter—are drilled through the first and second metatarsals. The first metatarsal is the bone located directly below the big toe, while the second metatarsal is located below the second toe. Next, two sets of metal cord are threaded through the holes and secured. Using X-ray images, the surgeon tightens the cords and forces the metatarsals into their correct positions.

Candidates for Tightrope Bunion Surgery

Although tightrope bunion surgery has benefits over Lapidus fusion and osteotomy, the procedure is not right for everyone. Unfortunately, the tightrope surgery cannot be used to treat very large bunions. Patients with a very thin second metatarsal should also consider other methods of treating their bunions.


Tightrope bunion surgery allows doctors to more precisely set the angle formed by the first and second metatarsals. Since X-rays are used during the surgery, the doctor can see exactly how close the foot’s intermetarsal angle is to the normal angle of 9 to11 degrees or less, before completing the procedure. Surgery for tightrope bunion also has shorter recovery periods than other bunion treatments, because the surgery is considered less invasive and no bone is removed from the foot.


Surgery for tightrope bunion does have the same risks as typical surgical procedures. These include infection, bleeding or blood clots. Some people experience breathing problems or an allergic reaction after being administered anesthesia. Numbness in the big toe or nerve damage can occur after bunion surgery. Unfortunately, the bunion can return after the procedure. Fracturing of the second metarasal is the most common problem associated with tightrope bunion surgery; therefore, older people may not be ideal candidates for this procedure, as their bones often take longer to heal.

Recovery Period

The recovery period for tightrope bunion surgery is about four to five weeks, opposed eight to 12 weeks for other bunion surgical procedures. Immediately after the surgery, the patient will be able to put on a postoperative, stiff-soled shoe or boot and walk on the foot. The dressings covering the surgical site will need to be changed weekly. Sutures are generally removed after two or three weeks.


Bunion Surgery Recovery: Tightrope Bunion Surgery


MedicineNet.com: New Bunion Procedure Aims to Replace Invasive Foot Surgery


University Foot & Ankle Institute: Hallus Valgus Bunion Surgery


Arthrex: Mini TightRope for Hallux Valgus Correction and Lisfranc Ligament Repair


UCLA Health System: New Procedure Straightens Bunions Without Bone Cutting


PubMed Health: Bunions


HealthCentral: Bunion Removal