Hallux-abducto-valgus or “bunion” surgery is one of the most common surgical procedures for the foot and ankle specialist. As our understanding of the hallux-abducto-valgus deformity has grown, it is becoming clear that the anatomic CORA of the deformity may lie at the tarsometatarsal joint. There is also the component of the 3-dimensional nature of the deformity that may be best addressed at this CORA. With these issues in mind, it was necessary to address the shortcomings of the traditional Lapidus procedure and progress toward more consistent, instrumented steps that could address the 3-dimensional nature of the deformity.