A chevron osteotomy is a surgical procedure used to correct bunions by cutting and repositioning the bone at the base of the big toe. The cut is made in a V-shape (like a chevron) through the head of the first metatarsal, the long bone that connects to your big toe. This allows the surgeon to shift the bone sideways, straightening the toe and eliminating the bony bump on the side of your foot. It’s one of the most commonly performed bunion surgeries worldwide, particularly for mild to moderate deformities.
Why the V-Shaped Cut Matters
The name “chevron” refers to the shape of the bone cut itself. The surgeon makes a V-shaped incision into the metatarsal head, which is the rounded end of the bone closest to your toes. This shape is intentional: the two angled surfaces created by the V interlock with each other after the bone is shifted, creating a naturally stable construct. That inherent stability is a major advantage over other bunion procedures, and it’s one reason the chevron osteotomy has remained popular since it was first described in the 1970s.
Once the V-cut is made, the surgeon slides the lower portion of the bone laterally (toward the outside of the foot) to correct the alignment. The shifted bone is then typically secured with one or two small screws. Any excess bone that still protrudes is shaved down to smooth the contour of the foot.
Who It’s Best Suited For
The chevron osteotomy works best for bunions that are mild to moderate in severity. Surgeons generally assess this by measuring the angle between the first and second metatarsal bones on an X-ray. When that angle is roughly 15 degrees or less, the chevron is often the preferred approach. For larger deformities where the metatarsal has drifted further out of alignment, other procedures that cut the bone closer to its base (such as a scarf or proximal osteotomy) can achieve greater correction.
Good candidates are typically people whose bunion pain hasn’t responded to nonsurgical measures like wider shoes, padding, or orthotics. The procedure is performed on adults of all ages, though bone quality matters. In older patients with significant osteoporosis, the bone may not hold the fixation as reliably, so the surgeon may consider alternatives.
What Happens During Surgery
The procedure is usually performed under regional anesthesia, meaning your foot is numbed but you’re not under general anesthesia (though sedation is common). Surgery typically takes 30 to 60 minutes and is almost always done as an outpatient procedure, so you go home the same day.
The surgeon makes an incision along the inner side of your foot near the big toe joint. After exposing the metatarsal head, they release tight structures on the outer side of the joint that are pulling the toe out of alignment, then make the chevron cut. The bone fragment is shifted into its corrected position and pinned in place with a small screw. The joint capsule and soft tissues are then tightened on the inner side to hold everything in its new alignment, and the incision is closed.
Recovery Timeline
Recovery from a chevron osteotomy is faster than many other bunion procedures, but it still requires patience. Most people can expect the following general timeline:
- First 2 weeks: You’ll wear a stiff postoperative shoe or boot and keep weight on your heel. Swelling and bruising are at their peak. Elevating the foot as much as possible makes a significant difference in comfort during this phase.
- 2 to 6 weeks: Stitches come out around the two-week mark. You’ll continue wearing the postoperative shoe but can gradually put more weight through the foot. Most people can manage short outings and light daily tasks.
- 6 to 8 weeks: The bone is typically healed enough on X-ray to transition into a supportive sneaker. Walking feels more normal, though stiffness in the big toe joint is common.
- 3 to 6 months: Swelling continues to decrease gradually. Return to exercise and more demanding footwear happens during this window. Some residual swelling, particularly at the end of the day, can persist for up to a year.
Most people return to desk work within two to three weeks, though jobs that require standing or walking may need six weeks or more off. Driving depends on which foot was operated on. If it’s your right foot, plan on four to six weeks before you’re comfortable braking safely.
Success Rates and Outcomes
The chevron osteotomy has strong long-term results. Studies consistently report patient satisfaction rates above 85%, with significant improvements in pain, appearance, and the ability to wear normal shoes. The procedure corrects the visible bump effectively, and most people experience a meaningful reduction in the angle of the big toe deviation.
Recurrence of the bunion is possible but relatively uncommon when the procedure is matched to the right severity of deformity. Choosing shoes with adequate toe room after surgery helps maintain the correction long-term.
Potential Complications
Like any surgery, the chevron osteotomy carries risks, though serious complications are infrequent. The most commonly reported issues include:
- Stiffness in the big toe joint: Some loss of range of motion is common, especially in the first few months. Consistent toe exercises during recovery help minimize this.
- Overcorrection or undercorrection: Occasionally the toe ends up slightly off the intended alignment. Minor degrees of this rarely cause symptoms.
- Avascular necrosis: The blood supply to the metatarsal head can be disrupted during surgery, causing a portion of the bone to lose its blood flow. This is the most talked-about risk specific to the chevron technique, though it occurs in fewer than 2% of cases when modern surgical techniques are used.
- Transfer metatarsalgia: Pain under the ball of the foot near the second or third toes can develop if the shortened first metatarsal transfers more pressure to neighboring bones.
- Hardware irritation: The small screws used to hold the bone in place occasionally become palpable or irritating under the skin. They can be removed in a minor procedure if needed, usually after the bone has fully healed.
How It Compares to Other Bunion Surgeries
The chevron osteotomy is one of over 100 described procedures for bunion correction, but in practice, surgeons choose from a handful of reliable options based on the severity of the deformity. For mild to moderate bunions, the chevron is favored because of its stability, relatively quick recovery, and predictable results. It involves a bone cut at the far end of the metatarsal (near the toe joint), which limits how far the bone can be shifted, typically around 4 to 6 millimeters.
For moderate to severe bunions, a scarf osteotomy cuts the bone in a Z-shape along the shaft, allowing greater correction. A Lapidus procedure fuses the joint at the base of the first metatarsal and is reserved for the most severe deformities or cases with instability at that joint. These larger corrections come with longer recovery periods and more restricted weight-bearing in the early weeks.
Minimally invasive bunion surgery has gained popularity in recent years. These techniques use very small incisions and specialized instruments to make bone cuts percutaneously (through the skin). Early results are promising, with potentially faster recovery, though long-term data is still catching up to the decades of evidence behind the chevron.