A common question we get here at Foot First Podiatry is what is the difference between the Sklar Bunionectomy® and Lapidus type bunion procedures?

There are three major differences between these two procedures: the cut in the bone, the cosmetic appearance, and the recovery.

Bone Cut

Lapidus type bunion surgeries typically are performed at the first metatarsal-cuneiform joint, and involves fusing this joint so it no longer moves ever again. This is done at the base of the first metatarsal closer to the top of the arch of your foot, not near the area of the bunion. The cut in the bone is usually fixated with screws and plates. The screws and plates used can be very expensive depending on the system the doctor chooses. Because this type of procedure fuses a joint it typically requires removal of bone, which in turn shortens the big toe in comparison to the lesser toes. There are also certain risks that a Lapidus type procedure exposes a patient to, such as higher risk of delayed or nonunion (the bones may not heal together), or elevated positioning of the 1st metatarsal.

The Sklar Bunionectomy® is a minimally invasive surgery performed at the first metatarsal-phalangeal joint where the bunion deformity takes place. We use two to three screws to fixate this procedure. Typically there is much less metal placed in a patients’ body than that is used with Lapidus type procedure. The cuts in the bone are placed in areas that heal consistently and predictably.

The biggest difference between the two procedures is recovery time. With a Lapidus type bunion surgery most patients are required to be bandaged and in a boot for 4-8 weeks after surgery. In addition to that, there is a high possibility of not walking and using crutches during this time. If surgery is performed on the right foot driving is prohibited.

With our Sklar Bunionectomy® the recovery is much more manageable. Our patients are able to step on their feet immediately after surgery. In fact, our patients walk out of surgery safely to their respective rides to take them home. They are to be bandaged in a surgical shoe for approximately two weeks, then they are able to get into a tennis shoe. We do limit our patient’s walking, however most are able to return to a desk job within about three days. We also do not restrict driving even if surgery is performed on the right foot.

Cosmetic Appearance

Fixing Feet Beautifully™ is our motto at Foot First Podiatry because we pride ourselves with not only how our Sklar Bunionectomy® functions, but also how beautiful it leaves a foot. There is a remarkable difference with how a foot that has healed from a Lapidus type bunionectomy has healed than with the Sklar Bunionectomy®. This is mostly due to the scarring that is left after surgery.

With the Sklar Bunionectomy® our small scars are hidden to the side of the foot where they cannot be seen. There is also minimal to no shortening of the big toe to make it look disproportionate to the other digits. This means that after a patient has recovered from surgery their foot appears as if it had never needed surgery in the first place: naturally beautiful.

With Lapidus type procedures there are typically one very long scar or multiple scars on top of the foot. Scars on top of the foot are not only unsightly, but can also create problematic scar tissue that can affect the end functional result of surgery as well. And also as stated above, there can be remarkable shortening of the big toe, causing an awkward looking appearance after surgery.

Below are two examples of Lapidus type surgical results:

Following that image of the two examples of Lapidus Type surgical results are comparisons of patients who have had the Sklar Bunionectomy® on one foot, and a Lapidus type procedure on the other:

The Sklar Bunionectomy vs Lapidus Type Surgical Results

Both the Sklar Bunionectomy® and Lapidus type procedures can offer good results when correcting a bunion, however the journey to the end result is drastically different, as well as the appearance. We at Foot First always recommend patients to read reviews, and ask for before and after pictures when choosing their surgeon and procedure. To us the obvious choice is always the Sklar Bunionectomy®.

Both procedures:

Involve cutting the bone and using hardware
Can offer correction of bunions of many shapes and sizes
May need removal of hardware

Lapidus type procedures:

More scarring/visible scarring
Shortening of the big toe
More internal hardware used
Longer and more involved recovery
Fuses a joint

Sklar Bunionectomy®:

No visible scars
Minimal shortening of the big toe
Manageable recovery

If you are thinking about having foot surgery, please explore our website at www.footfirst.com or connect with us on our Instagram handle @footfirstpod. You have choices when it comes to the type of surgical procedures you can have, so why not choose the one that makes recovery easy and your foot looking beautiful.