bfdadmin

bfdadmin

bfdadmin

Tuesday, 20 October 2020 16:17

Hallux Rigidus

Hallux

Hallux rigidus is a mechanical arthritic condition of the big toe joint. Overtime hallux rigidus limits the bending of the toes. Initially, the condition is not very painful and only slightly limiting. However, over time, it can lead to severe pain and complete blockage of motion. At our clinic, we specialize in treating Hallux Limitus.

Although the initial pain can be only slight, you should definitely have your feet examined by a foot and ankle specialist, because once the big toe joint wears out, the damage will be extremely difficult to reverse. In its final stage, hallux rigidus fully destroys the joint. 

Our doctors at Issaquah Foot and Ankle Specialists have treated hallux rigidus for years. Give us a call today at 425-391-8666 or make an appointment online today.

PlantarFibromatosisPain

Plantar fibromas
are benign soft tissue growth within the plantar fascia. This often present as a nodular bump in the instep. These are often painful especially with direct pressure. Patients will sometimes also have Dupuytren's contractu affecting their hands. They also often have a high arch foot structure. These are often diagnosed and confirmed with diagnostic ultrasound imaging and physical exam.
 
These can be difficult to treat. Typical treatments include prescription orthotics, cortisone injections, shockwave therapy, and ultrasound therapy. Surgical excision can be done, however there is a high recurrence rate. Prescription orthotics are particularly effective. These orthotics work by supporting the longitudinal arch to decrease the strain within the fascia. In addition prescription orthotics can have a plantar fascial groove.  This is where the Doctor marks the foot to show where the band of the plantar fascia bowstrings out especially when the great toe is raised or dorsiflexed.  This marked area will then transfer to either a plaster cast or the 3-D optical scanner. In addition, we often mark the plantar fibroma to make further create a depression within the orthotic here that is filled with soft but supportive foam. This way the foot has support but the areas that are most sensitive have much softer support and the orthotics do not "dig in to the arch". Other treatments such as cortisone injections ultrasound shockwave therapy are all helpful but are even more effective when combined with a special orthotics that have a "sweet spot".
 
If you have concerns about plantar fasciitis or plantar fibromas that you would like evaluated please let us know. Come see either myself Dr. Timothy Young, or my partner Dr. Brandon Nelson. Give us a call at 425-391-8666 or make an appointment online.
Bunion xray

There are many different types of bunion surgeries that can be performed. However the majority of bunion procedures are classified as either a head procedure or base procedure. Head procedures are all performed distally or at the tip of the first metatarsal. Procedures that are called base procedures are performed at the base of the metatarsal or at the metatarsal cuneiform joint. There are many different names for head procedures. However all of them involve some sort of cut in the bone or osteotomy. The osteotomy can be performed in many different fashions, however one of the most stable procedures is called an Austin or Chevron cut.

This cut performed exactly is prescribed in a Chevron type fashion. The bone is then shifted towards the second metatarsal reducing the large bunion. Often times screw fixation is performed and some additional shaving for burring of the bony prominence this time. There are many modifications you can perform to this type of bunionectomy that can help correct other pathologies of the first metatarsal as well. I recommend seeing somebody who performs a lot of bunionectomies as often times these procedures can be more complex than appreciated. If you have a bunion and are interested in surgical correction we are happy to help you schedule a consultation today. Give us a call at 425-391-8666 or make an appointment online.
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Surgical bunion correction is a common procedure at our clinic and our surgical center. During bunion surgery after the skin incision, subcutaneous layer is also dissected and then the joint capsule. The joint capsule serves multiple functions. One is to help stabilize the joint–much like the ankle joint has ligaments that stabilize your ankle. The inner layer of the joint capsule produces synovial fluid to lubricate the joint. During surgery this joint fluid comes out during the procedure.  

It can be helpful to replenish this joint fluid to help get the joint functioning properly again and moving like it should. There are different ways to accomplish this. We often inject sympathetic joint lubricant into the joint during the early postoperative time frame. The brand that we utilize is called Supartz. This was originally FDA cleared to help protect the knee joint and treat knee joint  symptoms. We use Supartz in many different applications within the foot and ankle. But after bunion surgery to get the joint moving again, is certainly one of them. This can also be very helpful if the patient has arthritis of the great toe joint and has to have a joint cleanup procedure to remove some of the bone spurs and repair cartilage.
 
If you have questions about bunions or bunion surgery, please come to our office for a consultation to see myself Dr. Timothy Young or my partner Dr. Brandon Nelson.
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Bunion surgery can be a complex surgery. It depends on the nature of the bunion deformity and the overall foot structure. There are many factors that go into bunion deformity correction. Complicating factors can include overall flatfoot for high arch foot or lesser digital deformities including hammertoes. However some bunions are straightforward and are easily corrected. It is important to see a foot and ankle specialist that does or has done a large number of bunion deformities.

I also recommend trying to find a physician that has a surgery center as this is a huge cost-savings and time-savings for the patient. The majority of bunion procedures can be divided into head procedure or base procedure. The larger bunion deformities require base procedure and a smaller bunion deformity can be corrected with a head procedure. I also recommend patients make a list of questions regarding their foot in the overall correction recovery process. It is very important that patients choose a physician that they are comfortable with. I currently have been practicing for about 15 years and have fixed too many bunions count. If you have a bunion deformity and are contemplating getting it corrected nursing once available for conservative measures give us call today at 425-391-8666 or make an appointment online.
bunionsurgery
Surgical bunion correction is a common procedure at our clinic and our Surgical Center. During bunion surgery after the skin incision, subcutaneous layer is also dissected and then the joint capsule. The joint capsule serves multiple functions. One is to help stabilize the joint–much like the ankle joint has ligaments that stabilize your ankle. The inner layer of the joint capsule produces synovial fluid to lubricate the joint.  

During surgery this joint fluid comes out during the procedure. It can be helpful to replenish this joint fluid to help get the joint functioning properly again and moving like it should. There are different ways to accomplish this. We often inject sympathetic joint lubricant into the joint during the early postoperative time frame. The brand that we utilize is called Supartz. This was originally FDA cleared to help protect the knee joint and treat knee joint  symptoms. We use Supartz in many different applications within the foot and ankle. But after bunion surgery to get the joint moving again, is certainly one of them. This can also be very helpful if the patient has arthritis of the great toe joint and has to have a joint cleanup procedure to remove some of the bone spurs and repair cartilage.
 
If you have questions about bunions or bunion surgery, please come to our office for a consultation to see myself Dr. Timothy Young or my partner Dr. Brandon Nelson.

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There are many sources of heel pain. Heel pain can be caused from a bone spur, stress fracture or the most common reason plantar fasciitis. Plantar fasciitis is caused by inflammation within your plantar fascia which is a big thick ligament like structure that supports the bottom of your foot. The fascia begins in your heel and runs to your toes.

This is why the most common spot for heel pain is right where the fascia attaches to your calcaneus or heel bone. With an increase in exercise or walking we see more stress on the fascia. This in turn can begin to create and inflammatory cycle and the beginning of plantar fasciitis. One of the best things we can do in the beginning is to stretch your calf muscles. I recommend stretching at least 3 times a day for about 2-3 minutes each session. One must make sure to stretch both the gastroc and soleous muscles. 

If you are suffering from heel pain or plantar fasciits we can help. Give us a call today at 425-391-8666 or make an appointment online.

buniontreatments

Do I need bunion surgery?

Quite a few patients ask this question. There are many factors that go into whether I think a patient should undergo surgery. Pain is the primary factor that I like to use for patients deciding whether or not they need bunion surgery. Another factor includes whether or not their second toe is affected from the bunion with something like a hammertoe occurring. Another important factor to consider is that a bunion is a progressive deformity and at some point usually requires to be fixed.

How long doesn’t take to recover from bunion surgery?

This is a much harder question to answer because there are many variables that play into this. The most important variable is the type of bunion surgery that was performed. It also depends on one's definition of recovery. Majority of patients we see are walking within 1 week and can return to normal activities as quickly as 6 weeks or as long as 3 months.

Doesn’t hurt to have bunion surgery?

I find this question very easy to answer yes bunion surgery can be uncomfortable. However, at our office we typically perform 3-5 bunion surgeries every week and are very well-versed in helping patients with pain management. Any type of surgery will typically produce pain as this is a normal an inflammatory response. The majority of people that we treat typically will take pain medications for approximately 1-3 days.

Can I still Drive after having bunion surgery?

This question really depends on the type of bunion surgery that is performed. A large majority of bunion surgeries the patient can drive as soon as they feel comfortable. The majority of patients will drive in a stiff shoe however some patients with larger reconstructions may not be able to drive for approximately 4-6 weeks.

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We have talked previously about timing for bunion surgery and how bunions progress over time.  The challenge is that it is never the right time for bunion correction surgery.  So what are your alternatives, how can you buy some time.  There are some different options.

What to do while you are waiting for bunion surgery:

-If it is joint pain, then we can put sympathetic joint lubricant into the joint to protect the joint and reduce pain.  This can last for many months with no down side as far as the cartilage and joint status goes.
-Prescription orthotics.  Especially if it's not yet a severe bunion, orthotics can shift pressure off the joint and improve gait.  They will not reverse a bunion but they can slow the progression down in some cases.
-Very roomy shoes that have a stiff forefoot.  These can also help protect the joint and at the same time keep pressure off the joint.
-Various bunion splints and great toe spacers made of silicone gel.
-Topical pain relieving gels and anti-inflammatories such as Voltaren gel.

What not to do while you are waiting for bunion surgery:

-Avoid cortisone injections as they can damage the joint.
-Avoid tight fitting shoes and unsupportive flip-flops or sandals.
 
If you have a bunion and would like to discuss treatment options.  We recommend that you come into our clinic for consultation. Give us a call at 425-391-8666 or make an appointment online today. 
Bunion xray

Contemplating bunion surgery can be an overwhelming task. Often times we see patients that have visited multiple practitioners. The best piece of advice I can give my patients is to be comfortable with the physician. There are many different types of bunion surgeries. The majority of bunion procedures can be broken up to either head or base procedures. The way to think about it is really large bunion deformities as base procedures and smaller bunion deformities can utilize head procedures.

The most common head procedures performed are the Austin bunionectomy or some form of a Chevron osteotomy. The most common of base type procedure is the Lapidus or arthrodesis of the metatarsal cuneiform joint. The procedure performed really dictates the postoperative recovery. The majority of patients we see are walking within the first week and usually do not take more than 3-5 days off of work. Another great things about Issaquah Foot and Ankle Specialists is we have an on-site surgery center which really reduces the cost and time. If you are contemplating bunion surgery we would happily discuss it with you and help you come up with the best available options.

Give us a call at 425-391-8666 or make an appointment online today.
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