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This patient had a very severe bunion deformityand a very unstable first metatarsal. This patient required fusion of the first metatarsal cuneiform joint using modern fixation devices which allow early weightbearing, as well as a metatarsal head osteotomy to fully correct her deformity. This resulted in a complete correction of bunion deformity without the possibility of recurrence. The patient was able to bear weight immediately. She is very happy with the results.