Osteotomy Surgery: Meaning, Procedure & Recovery

April 7, 2025
Dr. Harpreet Minhas

Introduction

Osteotomy surgery is a procedure doctors use to fix bone problems by cutting and repositioning bones. It helps improve joint alignment, balance weight on your feet, and reduce pain. When other treatments like shoe inserts, medicine, or physical therapy don’t work, surgery might be the next step. For foot and ankle problems, osteotomy can make a big difference by improving how you walk and preventing further joint damage.

At Sole Foot and Ankle in Valparaiso, Indiana, our expert foot doctors (podiatrists) specialize in performing osteotomies for foot and ankle issues. We use modern tools and techniques to create customized surgical plans that help each patient recover and move comfortably again.

Key Takeaways

Osteotomy is surgery that cuts and realigns bones to fix foot problems and improve movement.
It’s used for bunions, flat feet, hammertoes, and arthritis in the foot.
Most people recover in 6 to 12 weeks, depending on the procedure and how closely they follow instructions.
Like any surgery, it has risks, such as infection or slow bone healing.
A consultation with a podiatrist in Valparaiso can help you decide if it’s the right choice.

What Is an Osteotomy?

An osteotomy is a surgery where a bone is cut, moved, and held in a new position using screws, plates, or pins. The goal is to fix deformities, relieve pressure on joints, and help the foot work better. In podiatry, doctors use this technique to treat common foot issues and improve how patients walk and feel.

Why Is an Osteotomy Performed?

Doctors may recommend osteotomy surgery when the bones in your foot are misaligned or causing long-term pain that doesn’t improve with other treatments. Misaligned bones can lead to uneven pressure on joints and soft tissues, which over time causes pain, swelling, and even deformity. An osteotomy helps by cutting and repositioning the bone to create a more natural alignment and improve how your foot functions.

Here are some of the main reasons an osteotomy might be needed:

1. Bone Misalignment

When the bones in your foot or toes grow or shift out of place—whether due to genetics, past injuries, or wear and tear—this can cause uneven walking patterns and discomfort. An osteotomy can realign these bones to restore balance and reduce pressure.

2. Joint Problems

Misaligned bones can damage joints over time, leading to stiffness, swelling, and limited movement. By correcting the bone structure around a joint, osteotomy can relieve pain and prevent joint damage from getting worse.

3. Arthritis

In cases of early to moderate arthritis, especially in the big toe or midfoot joints, an osteotomy can be used to shift pressure away from the damaged area. This helps preserve the joint and delay or prevent the need for joint fusion or replacement.

4. Poorly Healed Injuries

If a broken bone doesn’t heal in the right position (called a malunion), it can affect how your foot works and cause long-term problems. Osteotomy allows the surgeon to correct the shape and alignment of the bone to restore function and comfort.

5. Pain and Trouble Walking Due to Deformities

Foot deformities like bunions, hammertoes, or flatfoot often cause pain when walking or standing. Osteotomy is frequently used in these cases to reshape and realign the bones, making it easier to walk comfortably and wear regular shoes.

Reasons for Osteotomy

Osteotomy surgery is often recommended when certain foot conditions cause pain, limit mobility, or interfere with daily life. These problems can make it hard to walk, wear shoes comfortably, or stay active. In many cases, conservative treatments like physical therapy, custom orthotics, or medications don’t provide enough relief—making surgery the next step.

Here are some of the most common reasons you might need an osteotomy:

1. A Bunion (Hallux Valgus)

A bunion forms when the big toe points toward the second toe, causing the bone at the base of the big toe to stick out. This misalignment can be painful and make it hard to wear shoes. Osteotomy helps by realigning the bone in your big toe, reducing the bump and improving how your foot functions.

2. A Hammertoe That Doesn’t Move Properly

A hammertoe is a toe that stays bent in a curled position. It often causes rubbing against the top of shoes, leading to corns, calluses, and pain. When the toe becomes stiff and non-movable, an osteotomy may be performed to straighten the bone and restore better alignment.

3. Flatfoot That Causes Pain and Trouble Walking

Flatfoot, or fallen arches, means the inside of your foot flattens too much when standing or walking. This can lead to pain in the arch, ankle, or heel and even affect the knees and hips. In more serious cases, an osteotomy can shift the heel bone or lengthen the arch area to rebuild the foot’s natural shape and improve support.

4. Arthritis in Your Big Toe or Midfoot

When arthritis affects the joints in your foot, especially around the big toe or middle of the foot, it can make every step painful. An osteotomy can reduce pressure on the affected joint by adjusting the surrounding bones. This may help preserve joint function and reduce the need for more invasive procedures like joint fusion.

5. Ongoing Foot Pain from an Old Injury

If you had a foot injury in the past that didn’t heal properly, the bones may now be misaligned. This can lead to ongoing discomfort, especially during movement or while bearing weight. An osteotomy can correct the bone position and restore more normal foot function.

How Do I Prepare for Osteotomy?

Preparing for osteotomy surgery is an important step to make sure the procedure goes smoothly and recovery is successful. Your podiatrist at Sole Foot and Ankle will guide you through each part of the preparation process so you know exactly what to expect.

Here’s what typically happens before surgery:

1. X-rays or Imaging Tests

Your doctor will take detailed X-rays or other scans, like a CT or MRI, to get a clear view of your foot bones and joints. These images help your surgeon plan exactly where and how to make the bone cuts during the surgery. Every foot is different, so this step is key to creating a surgical plan that’s right for you.

2. Medical History and Health Check

You’ll be asked about your medical history, including any conditions like diabetes, heart problems, or blood pressure issues. The doctor may also order blood tests or other screenings to make sure you’re healthy enough for surgery and anesthesia. If you take medications regularly, be sure to tell your doctor about them.

3. Understanding the Surgery and Recovery

Your podiatrist will explain the surgery in simple terms—what will happen during the procedure, how long it will take, and what kind of tools or hardware might be used (like screws or plates). You’ll also learn what to expect during recovery, including how long you’ll need to stay off your feet and when you can return to normal activities.

4. Medication and Recovery Planning

Before surgery, your doctor may ask you to stop taking certain medications—like blood thinners—that could increase bleeding during the procedure. You’ll also get advice on pain management after surgery. It’s a good idea to plan for help at home, especially during the first few weeks when you may need crutches or a walking boot.

What Happens During Osteotomy Surgery?

Surgery usually follows these steps:

You’ll get anesthesia to block pain.
The doctor makes a cut over the area to be fixed.
The bone is cut and moved into the right position.
Screws or plates hold the bone in place.
The incision is closed and bandaged.

Surgery time is usually 1 to 2 hours, depending on the type and location of the osteotomy.

What Are the Main Types of Osteotomies?

Jaw, Chin, Elbow, Spine, Hip, and Knee Osteotomies
While osteotomy can be done on many body parts, such as the jaw, chin, elbow, spine, hip, or knee, we focus on foot and ankle osteotomies at Sole Foot and Ankle.
Big Toe and Foot Osteotomies
These are the most common types in podiatry.
Bunionectomy with Osteotomy
This procedure is done to fix a bunion—a painful bump at the base of your big toe. The bone in your big toe is cut and moved back into alignment. Metal screws or pins hold it in place. This helps relieve pain, improve shoe fit, and make walking easier.
Flatfoot Correction
For flatfoot, your heel bone may be shifted inward (medial slide osteotomy) or lengthened (Evans osteotomy) to rebuild the arch. Sometimes, tendon repairs or joint fusion are added. This stops the foot from collapsing and helps your foot move better.
Digital (Toe) Osteotomies
For hammertoes or overlapping toes, small cuts are made in toe bones (Weil or phalanx osteotomy) to straighten them. This reduces pressure and helps your toes sit correctly in shoes.

Risks Associated With Osteotomy Surgery?

While osteotomy is generally safe, there are risks:

Infection at the surgical site
Delayed or failed bone healing
Nerve or blood vessel injury
Blood clots (rare)
Long-term pain or discomfort from surgical hardware

Doctors reduce these risks by using clean techniques and careful planning.

What Should I Expect During Recovery?

Recovery depends on the type of osteotomy and your overall health. Most people can expect:

4 to 6 weeks of no weight on the foot, using crutches or a boot
Gradual return to walking with doctor approval
Physical therapy to regain strength and motion
X-rays to check if the bone is healing properly

How to Help the Healing Process

Follow your doctor’s instructions
Keep your incision clean and dry
Don’t smoke—it slows bone healing
Eat a healthy diet with enough calcium and vitamin D

What Outcomes Can Be Expected?

Most osteotomies are very successful. People often feel less pain and walk better. Here’s what studies show:

Bunion surgery: 90–95% of patients are satisfied
Flatfoot correction: 85–90% have better structure and function
Toe surgery: Over 90% have less pain

When Is an Osteotomy Needed?

An osteotomy is needed when:

Non-surgical treatments don’t work
Your foot problem is getting worse
X-rays show damage to joints or bones
Pain affects your daily life or job

How Much Does Osteotomy Surgery Cost?

Surgery costs vary, but here’s a rough guide:

Without insurance: $3,000 to $7,000 for foot osteotomy
With insurance: You may pay $500 to $2,000, depending on your plan

At Sole Foot and Ankle, we help verify insurance and offer payment options.

Choosing the Right Treatment Plan

Every patient is different. At Sole Foot and Ankle, we use exams and X-rays to decide the best type of surgery and how to fix your foot. We work with you to set goals and make sure you understand the benefits and risks.

A Note from Sole Foot and Ankle

At Sole Foot and Ankle in Valparaiso, Indiana, we’re committed to giving you expert care for foot and ankle problems. Our podiatrists focus on safe, proven treatments to help you move better and feel better. If you’re dealing with foot pain or deformity, we’re here to help.