A bone positioning guide may be used as part of a bunion correction procedure. The bone positioning guide can include a bone engagement member configured to be positioned on a medial side of a first metatarsal of a foot and a tip separated from the bone engagement member by a distance effective to position the tip on a lateral side of a second metatarsal and in an intermetatarsal space between the second metatarsal and a third metatarsal. The bone positioning guide can also include a mechanism operable to reduce the distance between the bone engagement member and the tip, thereby causing the first metatarsal to move in at least a transverse plane to reduce an intermetatarsal angle between the first metatarsal and the second metatarsal.