American Orthopaedic Foot & Ankle Society

View all recommendations from this society

Released September 17, 2014

Don’t perform surgery for a bunion or hammertoes without symptoms.

Foot surgery for cosmetic reasons is not supported by medical research. Symptoms such as pain and limitations of activity are the most common reasons to pursue bunion or hammertoe surgery. Patients having surgery for bunions and hammertoes are at risk for a wide range of complications such as nerve damage, infection, bone healing problems and toe stiffness.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their health care provider.

How The List Was Created

In order to formulate this list, the American Orthopaedic Foot & Ankle Society Evidence-Based Medicine Committee reviewed the society position statements on foot and ankle care and solicited expert opinion from specialty leaders including the AOFAS Board of Directors to prepare an initial list of topics for the Choosing Wisely website. The Board of Directors of the AOFAS reviewed the initial list and approved five statements for further development. The Evidence-Based Medicine Committee members reviewed the scientific literature on each statement and presented draft statements with supporting evidence to the committee for discussion. Committee members also reviewed the Choosing Wisely campaign website to ensure that there was no duplication in proposed content and for proper formatting. The committee evaluated each statement and edited the statement wording and supporting references. Once consensus was reached, the 2014 list was finalized by committee members. The finalized list was then reviewed and approved by the AOFAS Board of Directors. The AOFAS disclosure and conflict of interest policies may be found at www.aofas.org/education/Pages/Education.aspx.

Evidence-Based Medicine Committee:
Sandra E. Klein, MD, Chair
Ian J. Alexander, MD
Avrill R. Berkman, MD
Patrick B. Ebeling, MD
Todd S. Kim, MD
Anthony Michael Perera, MBChB
Phinit Phisitkul, MD
Ruth L. Thomas, MD
Emilio Wagner, MD
James A. Meeker, MD

AOFAS Board of Directors:
Steven L. Haddad, MD, President
Bruce J. Sangeorzan, MD, President-Elect
Mark E. Easley, MD, Vice President
Thomas H. Lee, MD, Secretary
Jeffrey E. Johnson, MD, Treasurer
Lew C. Schon, MD, Immediate Past President
Judith F. Baumhauer, MD, MPH, Past President
Bruce E. Cohen, MD, Member-at-Large
Timothy R. Daniels, MD, Member-at-Large
Sheldon S. Lin, MD, Member-at-Large
Selene G. Parekh, MD, MBA, Member-at-Large

Sources

Bunions [internet] Rosemont (IL): American Orthopaedic & Ankle Society. Available from: http://www.aofas.org/footcaremd/conditions/ailments-of-the-big-toe/Pages/Bunions.aspx

Adult foot health [internet] Rosemont (IL): American Orthopaedic & Ankle Society. Available from: http://www.aofas.org/footcaremd/overview/Pages/Adult-Foot-Health.aspx

Lehman DE. Salvage of complications of hallux valgus surgery. Foot Ankle Clin. 2003;8(1):15–35.

Pfeffer GB. Cosmetic foot surgery: a step in the wrong direction . Am J Orthop. 2011;40(4):174.

Sammarco GJ, Idusuyi OB. Complications after surgery of the hallux. Clin O rthop Relat Res. 2001;(391):59–71

Scranton PE. Jr., McDermott JE. Prognostic factors in bunion surgery. Foot Ankle Int. 1995;16(11):698–704.

Wapner KL: Conservative treatment of the foot. In Coughlin MJ; Mann RA; Saltzman CL, eds. Surgery of the Foot and Ankle . Vol I. 8th ed. Philadelphia, PA, Mosby Elsevier, 2007, 147–148.