How soon can I walk after bunion correction? Can I walk the same day?

The simple answer is yes, you can walk the same day, with Lapiplasty 3D bunion correction, but first, lets start by discussing traditional recovery after traditional 2 D “osteotomy” surgery to better understand why this technique allows early weightbearing.

Most surgeons who do not utilize Lapiplasty bunion correction often referred to as 2 dimensional bunion surgery, allow no weightbearing after bunion surgery.  This is due to the fact the bone is surgically broken in half and fixated with one or more screws, resulting in a fragile and “bent” bone during the healing process. 

2 dimensional osteotomy procedure, bone if broken in half and fixated with two small screws.

Bone is cut in half in a 2 dimensional osteotomy, bone cut is marked in red. You can see a similar cut in 5th metatarsal.

The time frame for non-weightbearing after  2D surgery differs from surgeon to surgeon, but can be as short as 2 weeks, but range as long as eight weeks depending on the surgeon.    2D osteotomy surgeons usually have patient remain non-weightbearing for two to 4 weeks, then continue partial weightbearing in a boot for 2-4 additional weeks. 

Before discussing weightbearing plan for lapiplasty procedure patients, it is important to better understand why it is so different from traditional surgery.

Lapiplasty differs greatly from 2D surgery as it fully restores the normal intended alignment of the first metatarsal bone, from the source of the deformity, the abnormally unstable 1st tarsometatarsal joint.

Sesamoids bones should spaced evenly like snake eyes directly below metatarsal but are deviated towards the lesser toes due to rotation of the first metatarsal.

3D bunion repair is accomplishes this with specially designed reduction clamps and cutting guides, takin the finesse out of bunion surgery, and allowing the surgeon to realign the bone, eliminating the bump and restoring the toe to straight alignment before a single bone cut is made.  Once bone cuts are made, the joint is fixated as it is the origin of the deformity with two strong locking plates, but only after straightening the bone and taking the rotation out that is present in (87%) of bunions. 

The two strong plates that fixate the abnormal joint provide much more stability than two screws. For example, imagine you are handed a thin flat piece of metal and asked to bend it, you will likely be successful. Now take two plates made of the same piece of metal, and place them 90 degrees apart.. This is very similar to a structural I-beam that tall buildings are made of and provides much more stability and strength. Lapiplasty is similar to this due to the fact that two plates are used, one on the top of the joint and a second plate at 90 degrees to the first, creating a very stable construct. No other surgical company can do this, as a patent exists on this innovative repair.

Cutting guide used to cut bone in Lapiplasty, used to realign the bone, and then cut. In 2D osteotomy surgery the bone is cut/broken then moved into alignment, resulting in a bent bone and unstable joint.

So when Can I walk?  Well now that the differences are illustrated between 2D to 3D surgery above we can answer that question.  Immediately!

Yes, you read that correctly.  Now, does that mean you can walk around the block, of course not.   Patients are given a tall walking boot prior to surgery and can put weight on their foot to walk to the bathroom with something to assist their walking, either crutches or a walker.  Long distances it is recommended to use a knee scooter. Patients will walk flatfooted on the boot for 2-4 weeks.  By week for most patients are walking with a normal gait pattern in the boo until week 6 after surgery.   On this date an x-ray should confirm healing and you can transition to an athletic shoe with an insert to orthotic.   This is worn for 6 more weeks and return to normal activities occurs at this 12 week date.  High impact exercise does not begin until 4 months after surgery, but low impact exercise like walking, stationary bike, rowing machine typically begin at the 6 week mark, sometimes sooner for certain patients.

Don’t be fooled by physicians who state, I do lapiplasty, just with different plates or screws.  This is at very best misleading, at worst an outright deception to get you to book surgery with them, and will likely result in you being in a cast for 4 or more weeks non-weightbearing.  Click the link here to read more about Lapidus versus Lapiplasty.

Lapiplasty has many advantages over traditional surgery or “Lapidus “ correction but if you need to walk asap for work or to take care of loved ones, Lapiplasty 3D bunion correction is the procedure is the one for you.

If you would like a consultation please click here to schedule and appointment with Dr. Paul Steinke, the 3D Bunion Doc