Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

What Is Forefoot Surgery?

Forefoot surgery encompasses a range of procedures addressing conditions affecting the toes and the five metatarsal bones — the front portion of the foot that bears the impact of walking and push-off. Common forefoot surgeries include bunion correction, hammertoe repair, neuroma removal, metatarsal osteotomy for metatarsalgia, and plantar plate repair. At Balance Foot & Ankle in Howell and Bloomfield Township, forefoot surgery is one of the most commonly performed procedure categories in our practice.

Bunionectomy (Hallux Valgus Correction)

A bunionectomy corrects the angular deformity at the first MTP joint where the big toe drifts toward the second toe and the metatarsal head protrudes medially. The procedure involves cutting and repositioning the first metatarsal bone (osteotomy) or fusing the first TMT joint (Lapidus procedure) to correct the underlying angular deformity. The bony bump is shaved and the joint capsule is tightened. Recovery involves 6–8 weeks in a surgical shoe with restricted weight bearing, followed by gradual return to regular footwear over 2–3 months.

Minimally invasive bunionectomy — performed through small percutaneous incisions using specialized burrs — has gained significant popularity and is appropriate for mild to moderate bunions. Recovery may be slightly accelerated compared to open techniques.

Hammertoe Surgery

Hammertoe correction addresses the abnormal flexion deformity at the PIP joint of lesser toes. Surgical options include: arthroplasty (removal of a small piece of bone at the joint to allow straightening), arthrodesis (fusion of the PIP joint in a straightened position), and flexor tendon release for flexible deformities. A K-wire (temporary pin) is often used to hold the toe straight during healing and removed in the office at 4–6 weeks. Weight bearing in a surgical shoe begins immediately. Return to regular shoes takes 6–8 weeks.

Morton’s Neuroma Excision

When conservative treatment of Morton’s neuroma fails, surgical excision removes the thickened nerve from between the metatarsal heads. The dorsal (top of foot) approach is most common and allows immediate weight bearing. Return to regular shoes takes 2–4 weeks. Recurrence or stump neuroma formation is a potential complication in a small percentage of cases.

Weil Osteotomy for Metatarsalgia

For metatarsalgia caused by a plantarflexed (downward-directed) metatarsal head, a Weil osteotomy cuts the metatarsal and shifts it dorsally (upward), reducing plantar pressure under the affected head. Multiple metatarsals can be addressed simultaneously. Recovery involves protected weight bearing in a surgical shoe for 4–6 weeks.

Key Considerations for Forefoot Surgery Patients

Forefoot surgery is elective in nearly all cases — surgery is chosen when conservative treatment has genuinely failed and pain significantly impacts daily life. Surgical timing should accommodate personal schedules: forefoot surgery requires several weeks in a surgical shoe and restriction from regular footwear, making timing around major events and work responsibilities important.

Swelling persists for 6–12 months after most forefoot procedures, and final results — both functional and cosmetic — cannot be assessed until this swelling fully resolves. Setting this expectation beforehand prevents frustration during healing.

If you’re considering forefoot surgery, contact Balance Foot & Ankle for a thorough evaluation and a candid conversation about whether surgery is appropriate, what the procedure involves, and what recovery looks like for your specific case.

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Balance Foot & Ankle — Howell & Bloomfield Township, MI

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Considering Forefoot Surgery?

Forefoot surgery addresses conditions like bunions, hammertoes, neuromas, and metatarsal fractures that do not respond to conservative treatment. At Balance Foot & Ankle, Dr. Tom Biernacki performs minimally invasive forefoot procedures with faster recovery times and less post-operative pain.

Learn About Minimally Invasive Foot Surgery | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Trnka HJ. Osteotomies for hallux valgus correction. Foot and Ankle Clinics. 2005;10(1):15-33.
2. Coughlin MJ, et al. Surgery of the foot and ankle. 8th ed. Mosby Elsevier. 2007.
3. Vernois J, Redfern DJ. Percutaneous surgery for severe hallux valgus. Foot and Ankle Clinics. 2016;21(3):479-493.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

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Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.