A positional bunion is a bony growth on the base of the big toe. It enlarges the joint. In a positional bunionectomy, the bump is removed and some soft tissue that has tightened may be released. Afterwards, you might have to wear a special surgical shoe or a splint.
Structural bunions occur when the angle between the first and second toe bones increases beyond normal. Sometimes bony growths may form, resulting in irritation and swelling. In a metatarsal head osteotomy, the bone is cut and repositioned. Any bumps are also remolded. Afterwards, you may have to wear a surgical shoe or cast until the bone heals.
Severe structural bunions result when the angle between the first and second toe bones is excessive. To treat these, a metatarsal base osteotomy may be conducted. A wedge of bone is removed from the base of the first metatarsal (large toe) bone and the bone is repositioned. Wires or screws may be inserted to stabilize the bone. Afterwards, you may have your foot in a cast.