The objectives of surgical treatment are two-folds

The main purpose of human foot is for function (walking, climbing, running and jumping), and bunion deformity is mainly a function problem. Despite its unsightly appearance, bunion surgery should only be function oriented. In order to restore normal function of the foot, its bony skeleton has to be maintained in its original shape and position. In so doing, cosmetic correction will have to be guaranteed. However, cosmetically oriented bunion surgery means invariable reshaping of the bone and may very well damage the function of the foot.

Metatarsus primus varus: It means the first metatarsal bone tilts towards midline of the body. This change starts the domino effect of all other associated deformities in bunion foot.

The primary objective of hallux valgus surgery is to restore normal function of the forefoot, which can only be expected from restoration of normal forefoot anatomy. Since metatarsus primus varus (sideway tilting of the first metatarsal bone) is regarded as the primary deformity, its correction is unquestionably considered the primary surgical objective. In most cases when the primary deformity, metatarsus primus varus, is properly corrected, then secondary deformities, such as hallux valgus, bunion and sesamoid subluxation, can be expected to correct on their own.

Primary surgical objective should not be too much sidetracked by cosmetic concerns because cosmetic correction would always come hand in hand with surgeries that restore normal anatomy and function. But best anatomical and functional results may not necessarily come with cosmetically oriented surgeries.