All patients were admitted to a dedicated outpatient surgery ward on the day of the intended procedure. All procedures were performed under general anesthesia with local anesthetic ankle block for postoperative analgesia using the maximal individual dose of levobupivicaine (2 mg/kg). Surgeries were performed using pneumatic tourniquets with exsanguination using an Eshmarch bandage. Both feet were draped simultaneously. A number of surgical procedures have been described to correct the deformity of the first ray in hallux valgus, and several authors have published treatment algorithms to simplify the surgical management of this condition. This can be particularly difficult for people with jobs that require them to be on their feet all day (hairdressers, lawyers, teachers, etc.). Most people who are recovering from bunion surgery will use crutches or some kind of walker for the first couple of weeks, and may also require special orthopedic shoes (your podiatrist will usually provide them for you if you need them). Because of the long recovering time necessary for bunion surgery, many people with bunions, or with the big toe deformity hallux valgus , put off the surgery. Bunions can also be associated with different diseases, such as cerebral palsy, Down's syndrome, Ehler-Danlos syndrome, multiple sclerosis, and different forms of arthritis. Bunions are often considered a hereditary condition, but you don't have to have a family member with bunions to develop them. Now mention orthopedic shoes, shoes lined with fleece, bunion pads, insoles, or orthotic arch supports to a bunion sufferer talking about hallux valgus and watch the look on their face change to sheer joyfulness. These types of solutions can take away the pain experienced in the bunion, and result in happy feet. So, I went to the Dr. today in hopes that my boot cast would be left behind. He said that I've been a great patient, and that he can see that I've taken excellent care of my foot. That I have the least amount of swelling one could have at 6 weeks post op. I've remained home through all events, party's, and holidays. Thanksgiving with family, and Yes, even New Years Eve, while my friends watched the ball drop in New York City from the New York Palace Hotel! I chose this, and hoped it would be worth every bit of the sacrifice. My second opinion Dr. has reviewed all of my xrays from beginning to end, and said that he feels my foot is not going to be sound, if and when the bone does unite. He has NO reason to lie because he's not local or in my insurance network, so he cannot do the repeat surgery anyway. He feels strongly that the surgery will need to be repeated and that I am being strung along. That the surgery done on me was more the style a dr. would do for an old person, so that they can get around. Not a young person or athlete like myself. Decompression of the first metatarsophalangeal joint (MPJ) is necessary to allow IM angle reduction and prevent postoperative jamming of the joint and valgus subluxation of the hallux. In my experience of performing first MPJ arthroplasties with or without total joint replacement and fusion, resecting either component of the first MPJ (i.e., via Keller or Mayo procedures) reduces the retrograde forces from the hallux valgus deformity. This leads to decompression of the joint. As a result, the IM angle reduces usually as much or more than with a base wedge procedure.