Not many hospitals treat bunions alone, usually using minimally invasive or simple soft tissue release surgery. For refractory and severe cases there is no system to carry out, and the treatment is not systematic because no specialized foot and ankle surgery specialty has been established. Even if the surgery is performed by famous professors at home and abroad, the results are still unsatisfactory to varying degrees due to the many ways and individualized conditions. Our hospital has been carrying out the procedure for 3 years, and recently we have introduced tools such as miniature pendulum saws, which greatly facilitate the operation. Soft tissue surgery consists of three main parts: (1) removal of the medial tuberosity of the first metatarsal head; (2) release of the lateral soft tissue of the first metatarsophalangeal joint, including [the severance of the medial retractor tendon and the incision of the lateral joint capsule; and (3) strengthening of the medial soft tissue of the first metatarsophalangeal joint and tightening of the joint capsule with sutures. The main methods are the Silver and McBride procedures, some of which require simultaneous [wedge osteotomy of the proximal phalanges of the toes (Akin procedure). This type of surgery is mostly suitable for patients with mild bunion deformity, mainly manifesting as [capsular inflammatory symptoms. Bone surgery: 1. The most commonly used distal metatarsal osteotomy at home and abroad is the Chevron osteotomy, in which the distal metatarsal head is pushed outward after herringbone osteotomy and fixed with a single Clinique pin or dowel pin. It is suitable for patients with mild to moderate enlargement of the intermetatarsal angle. 2.Metatarsal stem osteotomy: Scarf and Ludloff osteotomies are commonly used at home and abroad for patients with moderate to severe enlargement of the intermetatarsal angle, with the advantage of complete correction, and the disadvantage that the time to go down is later than distal osteotomies, and higher surgical skills are required. 3.Metatarsal base osteotomy and fusion of the first metatarsal cuneiform joint: base osteotomy is suitable for patients with severe intermetatarsal angle enlargement, because it has the disadvantage of postoperative metatarsal head elevation, so the clinical use is only for some special cases. Metatarsocuneiform joint fusion is commonly used in patients with unstable first metatarsocuneiform joint or [ectropion with osteoarthritis of the first metatarsocuneiform joint, and the commonly used procedure is: Lapidus surgery. 4. Patients with arthritis in the first metatarsophalangeal joint have 3 options: ①Keler surgery: for those who are too old and frail to tolerate prolonged surgery or only require local pain resolution. ②Joint fusion: for those who are physically active or prefer sports. ③Artificial metatarsophalangeal joint replacement: for patients who require better post-operative joint movement, easy work and good economic conditions.