I have been practicing medicine now for about 15 years and like to look back from time to time on how it has changed.  Currently there is a lot of talk about the Lapiplasty bunion and bunion surgery in general.  I thought I would take a few minutes and discuss this topic. 

Bunion surgery continues to be one of the most common foot surgeries in the United States if not the most common.  I believe the last statistic I read was something like almost 350,000 operations per year.  It is hard to believe there are that many bunions out there!

The most utilized bunion surgery is the Austin bunionectomy.  This is for a couple reasons.  One can correct the vast majority of bunions whether small or large.  It has a much faster recovery and is technically not as challenging as other operations.  It involves the cutting of the metatarsal head in a chevron pattern and shifting that bone medially.  It is usually fixated in place with a few screws.  Patients can bear weight immediately and are typically in a walking boot for 4-8 weeks.  It has good long term results and will probably continue to be the most common bunionectomy for that reason. 

The other most talked about bunion procedure is the Lapidus bunionectomy or the Lapiplasty.  This procedure is the choice for very large bunions or juvenile bunions.  It is technically more challenging but provides for excellent correction.  This involves fusion of the metatarsal cuneiform joint to realign the metatarsal.  It  usually involves a period of non weight bearing from 3-8 weeks.  The long term results are excellent. 

That begs the question: which procedure is best for bunion patients?  Well the answer is not simple.  It really involves a couple key considerations.  First being how does the rest of the foot look and how much motion do we have through the 1^st metatarsal?  Second is patient age and activity level.  Third would be overall general health of the patient and bone quality.  I recommend seeing a surgeon that performs a lot of bunion surgeries as their outcomes will be better.

If you have a bunion and would like to know your options and have it evaluated schedule, make an appointment with me and I will help you. 

Sincerely,

Brandon Nelson

Board Certified Physician & Surgeon

Issaquah’s Top Podiatrist & Foot/Ankle Surgeon

Bunion surgery has been around for over 100 years. There are many techniques that have been utilized for correction of a bunion.  The majority involve cutting a bone and realigning a joint.  The goal of these surgeries are to straighten the 1^st metatarsal and eliminate the deviation of the bone.  Today with new research and modern technology we have a better understanding of function anatomy and have begun to look at bunion surgery outcomes.  This has led the majority of us surgeons to utilizing the Lapiplasty technique for better long term outcomes.

I personally have been a Lapidus surgeon for over 15 years.  I trained in the Northwest and have had the opportunity to work with some of the pioneers of bunion surgery.  We have seen through research that the Lapidus procedure holds up the best over time.  The long term outcomes show very little recurrence and better overall patient happiness.  The lapiplasty system has allowed us to take the lapidus bunion procedure and make it more reproducible. 

Lapiplasty is a system created by Treace Medical that has taken some of the technically challenging parts of the lapidus bunionectomy and simplified them.  It has a system of cutting jigs and guides that make it simple to correct the bunion.  I find patients are extremely happy and have seen incredible long term results.  If you have a bunion schedule and appointment with me, I can help you review your options. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr Brandon Nelson 

I have been operating on bunions now for over 15 years and have performed 1000’s of bunionectomies.  I continue to enjoy working on bunions as the surgical results are satisfying for both the patient and physician.  Bunions come in all sizes and present in all ages from teenagers to adults.  Many patients seek out care for bunions and some choose to have them fixed.  It is important to note that not everyone is a surgical candidate and not every bunion requires surgical intervention. 

Surgical care for a bunion can provide excellent results.  One of the most common procedures is the Lapiplasty bunionectomy.  It has shown exceptional follow up and long term outcomes.  I find the Lapiplasty to be very reproducible and have high patient satisfaction.  It is not appropriate on every patient nor is it the only bunion procedure I find highly successful.  

My office has an onsite surgical center that we utilize for bunion surgery.  It is a significant cost savings and time savings for patients.  It utilizes monitored anesthesia care with a nerve block of the lower extremity.  If you have a bunion and would like a consultation please feel free to call the office at 425-391-8666 or schedule an appointment online.

Sincerely,

Dr Brandon Nelson

Bunions can be quite painful for many people.  They can begin to interfere with activities and make exercising difficult.  Additionally, it can become difficult to find shoe gear that fits properly.  Most bunions are a genetic condition that is inherited and develops with time and loading of the foot.  Many bunions get bigger as time goes on and eventually require surgical repair.  Surgery for a bunion can be broken down into two categories what are called head procedures and base procedures.  Today I will only discuss a base procedure as this seems to be the most common question lately.

Base procedures are often used for large bunions and can be a powerful tool to correct the foot.  The base procedure is usually further divided into joint sparing procedures and joint destructive procedures.  The most asked about procedure currently is the Lapiplasty.  The Lapiplasty is a procedure based off a technique described by Paul Lapidus.  It involves removing a joint in the foot that is the apex of the bunion deformity.  The reason this procedure is so effective is it eliminates the primary cause of the bunion, the hypermobile joint that initiated the development of the bunion.

Lapiplasty is a tool set that is provided to make the Lapidus bunion surgery easier.  This is a technique that has been utilized for years however this instrument set is the first of its kind and has helped make this procedure more reproducible.  This is the most common bunion procedure I execute as it has great correction and great long-term outcomes.  If you have a bunion and would like a consultation, make an appointment today and I can help.

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

Sincerely,

Brandon Nelson

Board Certified Physician and Surgeon

People with a painful bunion often begin to contemplate bunion surgery. Bunion surgery is a great option for patients who are wish to relieve symptoms cause by bunions.

There are many different types of bunion surgeries. Bunion surgeries are based on the size of the bunion and the individual foot structure. The majority of bunion surgeries require and incision on the top of the big toe joint. The procedure then involves removing and realigning bone and soft tissue of the big toe joint. If any other foot issues are present, like a flatfoot, these should be fixed at the same time.

Scheduling an appointment to have your bunion evaluated is the first step. Dr. Nelson will discuss your x-rays and all of your options. He will present both conservative and surgical and help you determine what is best. Some common questions include:

-Surgery is done one foot at a time

-The majority of bunion surgeries are less than 2 hrs

-Patients are sedated during the procedure and this is done in the office

-Pain medication will be prescribed for when the nerve block wears off

-Walking without crutches is possible for most people

The recovery can vary from patient to patient. However, most people can bear weight after the procedure. It is important to follow all post-op instructions carefully. If you have a painful bunion and want to know what options are available and live in Issaquah, Sammamish, Snoqualmie, Bellevue, Seattle, Kirkland or Maple Valley give us a call so we can help.

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

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.

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.

The most common surgical procedure I perform by far is a bunionectomy. The bunionectomy procedure itself can be very rewarding for patients and physicians like. Often times patients come in with a significant amount of foot pain and a history of multiple conservative modalities have been attempted all to no avail. These people are obviously good candidates for surgical correction. Additionally I see a lot of patients that are currently not in pain however have a hard time fitting shoe gear or have a large bunion a family history of bunion deformities.

Surgical intervention is often warranted for patients that have a family history of bunion deformities or have a hard time fitting in shoes. A few patients come in with a large bunion that doesn’t have pain. Initially it is important to evaluate the patient from a clinical standpoint and radiographic standpoint. Often times on the x-ray we’ll see the beginning of arthritis and correcting the bony can help reduce the chance of long-term arthritic changes. I recommend patients that have a bunion to release be evaluated. That way we can at least implement conservative measures. 

At Issaquah Foot and Ankle Specialists we average about 3-5 bunion surgeries every week. We find a lot of variation in bunion deformities from pediatrics bunion to Tailor's bunions. Bunions can have many different causes and it’s important to address all these deforming forces in order to maximize outcomes. Some people benefit from what's called a distal or metatarsal head procedure, others will need a more proximal or base procedure.

The majority of bunion procedures we performed patients are usually walking the first day after surgery. The limiting factor is usually swelling or pain at the operative site. We try to encourage patients to ambulate early and do functional range of motion quickly to maximize outcomes. The majority of bunion surgeries we provide at our clinic have great and quick outcomes. If you have bunion pain additionally we have many conservative options that we can provide for patients.

I treat a lot of runners in the office for all sorts of foot and ankle pain. I am a runner myself and so I enjoy treating these patients. It seems as though a lot of runners have foot deformities and one of most common is a bunion. It is important to note that the bunion itself can grow larger with increased activities like running. Running and bunions can be challenging from a structural standpoint and from a pain reduction standpoint. I feel like I have a lot of tools at my disposal to help runners become pain free with activities.

The majority of runners I see are great conservative candidates and become extremely happy with their progress. There are a few patients that do not respond to conservative measures and require surgical intervention. It is very important for runners to seek a physician that has a lot of experience dealing with runners in their clinic. This is especially important when contemplating surgical intervention and I can tell you I am extremely cautious with procedure selection on runners. If you have a bunion and are getting pain with running you may be a candidate for conservative measures or surgical measures. I would love to help you keep running happy trails!

Give us a call at 425-391-866 or make an appointment online today.