Correction of bunion deformities has been the mainstay of foot and ankle orthopedics. A bunion is a protuberance on the inner border of the foot near the base of the great toe. Nearly every foot has some bulge in this area- the name bunion is reserved for those larger than average bumps that have a propensity to cause painful problems. For a bunion to become painful, there has to be pressure or friction on the skin and soft tissues overlying the bump. Therefore, shoewear is always part of the problem, and often can be part of the solution. Ill-fitting shoewear has long been blamed for production of bunions, but in most cases it is the inherited anatomy of the foot which plays the major role in creation of a painful bunion. The metatarsals are the row of five long bones in the forefoot which each connect to the base of the corresponding toe. They fan out slightly from the narrower midfoot area. In many individuals, the angle between the first and second metatarsal is enlarged, an inherited trait called metatarsus primus varus. Individuals who inherit this trait are at much greater risk of developing painful bunions than those with smaller angles. Over the years, correction of bunion problems has focused more and more on reduction of this angle, in addition to removal of the bony prominence. There are many choices of surgical correction of this deformity, your surgeon can advise you which option has the best chance of optimal correction, coupled with the least chance of post operative complications.