bunion issaquah

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Bunion xray

Bunion surgery has been around for more than 100 years.  It is one of the most common surgeries performed in the United States.  Over 100,000 are done annually and the majority are on women.  In recent years new advancements have been made to speed recovery and success of the operation.

The Lapiplasty system by Treace Medical is at the forefront of bunion repair.  This system has taken years to develop and has undergone evolution as it has been utilized.  It has now proven to be one of the work horses of bunion surgery.  It provides reproducible results and long-term correction.  It has an ease of use that makes the surgical procedure faster and improves recovery.  This has changed bunion surgery for patients and surgeons.  The Lapiplasty system is based on a long-standing surgical technique.

This long-standing technique was first described around the turn of the century by Paul Lapidus.  He advocated that the bunion started from the tarsometatarsal joint, and correction needed to occur there.  Since his original thought we have only worked to improve and support this theory in the surgical community.  It has been shown this is the center of most bunions and the correction is best done here.  If you have a bunion the time has never been better to have it fixed.   

Lapiplasty is by far the most successful bunion surgery technique I have seen.    If you are experiencing bunion pain, I can help call to make an appointment with me at 425-391-8666.


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Bunion xray

Bunions are one of the most painful foot conditions for patients that are active and can be extremely challenging for shoe gear.  This is related to the fact that the forefoot begins to widen, and the 1st metatarsal phalangeal joint can become dislocated.  If you are experiencing these issues, it could be time to consider fixing the problem permanently. 

Bunion surgery techniques have changed dramatically over the last 5 years.  This is primarily due to the advent of Lapiplasty.  Historically the Lapidus bunion procedure has had an outstanding result.  However, the limiting factor was recovering times.  The new Lapiplasty system has changed this and improved outcomes and decreased recovery times.  This has led me to change my technique to take advantage of this newer system to help my patients. 

My patients have been extremely happy with the newer system. They have seen the normal recovery time cut in half.  I used to see patients get into normal shoes at about 3 months and now this is around 6 weeks.  If you want a quicker return to normal shoes, come, see me and we can evaluate whether you are a candidate for lapiplasty.  I truly believe the best long-term results can be achieved and this is correlated with better stability of the foot.  Bunion surgery has never been easier!

If you are experiencing bunion pain, I can help call to make an appointment with me at 425-391-8666 or fill out a contact form online

Sincerely,Dr Brandon Nelson

American College of Foot & Ankle Surgeons

austin bunionectomy

Today we find ourselves in a new era of healthcare.   We have robots and small cameras and new instruments to utilize to improve outcomes and simplify procedures.  When I completed residency 15 years ago we were introduced to these new devices.  It has been interesting to see the evolution of these tools and new and exciting tools enter healthcare.  One of the most advanced instrument sets I have seen is the Lapiplasty system by Treace Medical.  This has revolutionized bunion surgery and made the surgeons part much easier and more reproducible.  

The lapiplasty system is based on the lapidus procedure that was first described by Paul Lapidus almost 100 years ago.  This procedure has been utilized in the Pacific Northwest for years.  When I began my training the lapidus procedure for bunion correction was very popular as it provided great outcomes with low recurrence rates.  The new lapiplasty system is based on the original surgical procedure but has tools that make the surgery easier to execute and recovery faster for patients. 

The advantages of patients are numerous and I will discuss a few.  First off any surgery should be reproducible.  The jig and cutting system of the Lapiplasty has taken away the variability among surgeons and removed eyeballing of bone cuts. This makes for better long term outcomes and reliable positioning of bones for correction of bunions.  Secondly it provides better fixation that allows faster recovery.  Traditionally the Lapidus procedure can take quite a long time to transition to weight bearing and a normal shoe.  This is a big advantage for the new Lapiplasty and one of my most favorite parts of the system.

If you have a bunion and would like to discuss Lapiplasty make an appointment with me today.  Give us a call at 425-391-8666 or make an appointment online today.

Dr. Brandon Nelson 

Bunion xray

Bunion surgery
has been performed for years and many different types of surgical techniques exist.  The last few years a newer procedure called the Lapiplasty has been pushed to the forefront of surgical correction.  It involves previously researched correction techniques combined with a newer jig for bone cuts.  It is the fastest growing bunion surgery in the United States.  There are a few key steps that make a difference in the correction that must be carefully followed.

The first key step is freeing up the joint so it can be rotated in 3 different planes to correct the triplane bunion deformity. 

The second involves making sure to release and mobilize soft tissue around the big toe.

Next provisional reduction needs to be done and fixated with a clamp to apply the cutting jig.  Once the correction is obtained the jig is placed and the bone is cut. 

The wedges of bone are removed, and the joint is fenestrated to promote fusion and graft can be placed.

The joint is then compressed, and correction again obtained, and fixation occurs with plates and screws.

The advantages of this system are reproducibility and stable fixation which allows earlier weight bearing. 

If you have a bunion and are in pain, I can help.  Make an appointment with me today at 425-391-8666 or fill out a contact form online

Dr Brandon Nelson
Issaquah Foot and Ankle Specialists

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Bunions are primarily an inherited foot structure issue.  These often begin to develop in early adolescents and progressively get bigger as time goes on.  They develop as one’s foot becomes increasingly unstable through the medial.  The bunion itself seems to grow as the first metatarsal shifts outwards and the big toe begins to drift into the adjacent digits.  This shift will continue until it is treated and will get larger as time and milage gets greater.

There are many different ideas about the treatment of a bunion.  There are conservative and surgical options available.  It is important to note that conservative options do not correct the bunion or stop it from getting larger.  This can only be accomplished surgically.

Surgery for a bunion is most used for long term correction.  Meaning realigning the bone for the foot to function in a stabilized fashion.  Many bunion surgeries are what is called a head procedure.  This is when the metatarsal head is cut and pinned or screwed in place.  The procedure itself is straight forward and can usually be done in under an hour.  The average person will be walking the entire post operative phase and can be in a normal shoe in 4-6 weeks typically. 

If you have a bunion and are in pain, I can help.  Make an appointment with me today at 425-391-8666 or submit a contact form online and our team will reach out as soon as possible.

Dr Brandon Nelson

American College of Foot & Ankle Surgeons

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Dr Timothy Young
, a board certified foot surgeon talks about Reversing a Bunion: Understanding the Causes, Treatment Options, and Prevention Part 1


Bunions are a common condition that can cause foot discomfort, pain, and limit mobility. Bunions are typically associated with a bony protrusion at the base of the big toe, and they are actually the result of a complex structural deformity in the foot.  We will review the causes of bunions, explore the available treatment options, and discuss preventive measures that can help reverse this condition.

Understanding Bunions:

Bunions, are also known as hallux valgus.  This condition occurs when the joint at the base of the big toe becomes misaligned. The misalignment causes the big toe to angle inward, towards the other toes, leading to the formation of a bony bump on the side of the foot. Bunions can be hereditary, but they are often aggravated by certain factors, including:

a. Footwear: Tight, pointed shoes that squeeze the toes together can contribute to the formation of bunions.

b. Foot structure: Certain foot types, such as very pronated flat feet with low arches, are more prone to develop bunions.

c. Arthritis: Certain forms of arthritis can increase the risk of developing bunions.  And conversely, bunions can lead to abnormal joint wear with potential for arthritis.

Treatment Options:

While bunions are generally progressive and often worsen over time, there are several treatment options available to address the symptoms and reverse the condition:

a. Non-Surgical Treatments:

Wearing good footwear: look for wide-toe shoes with a low heel and nice arch support can reduce discomfort.

Orthotic devices: prescription custom-made shoe inserts (orthotics) can help stabilize the foot and reduce further progression of the bunion.

Padding and taping: Using padding or taping around the bunion that will provide cushioning and reduce pain.

*If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today.

Bunion xray

A bunion is a common foot condition I see at my clinic.  It is amazing the different sizes and shapes of bunions I have seen during my career.  There are a couple of things I have noted during this time.  One is that the bunion gets bigger.  It does not grow but the bone continues to move out of alignment.  Secondly it is easier to fix earlier in the process especially when the other toes are not involved.  Lastly, the most important aspect is proper procedure selection.  This leads me to my discussion today.  The Lapiplasty has really revolutionized bunion surgery.

I was listening to a lecture today and they were discussing the fact that there are over 150 different types of bunion surgery.  Most of these techniques are no longer utilized.  But this is important because it illustrates how difficult it can be to get long term corrections.  This is why I am a fan of the Lapiplasty procedure.  The Lapiplasty corrects the bunion at its apex.  It helps to realign the bone in all 3 cardinals planes that the body moves in.  It has helped surgeons to provide the best correction for the patient and speed recovery.  I find this procedure has incredible outcomes and my patients are happy with their results. 

If you are suffering from a bunion I can help.  I have seen how painful and debilitating these can be.  Make an appointment online or give us a call at 425-391-8666


Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Bunion xray

There are many different types of bunion surgeries.  The majority that are performed currently can be divided into two types.  The first being a procedure at the head of the first metatarsal and the second at the base of the first metatarsal.  The recovery and healing time frames vary according to which procedure a patient has.

Head procedures or an Austin type bunionectomy is the most common bunion surgery in the United States.  I believe this represents something like 70% of all bunion surgeries.  These procedures are much faster to heal and typically a patient can bear weight the entire postoperative course.  The typical patient can be back in a shoe at about 6 weeks and return to full activities about 3 months. 

Base procedures or a Lapidus type or Lapiplasty often requires longer to heal.  Additionally there is variation among weight bearing with these cases.  Some doctors will allow immediate weight bearing and some will require 6-8 weeks of non-weight bearing.  Again, most people can return to activities about 3 months and into a normal shoe around this time as well.

Things that can improve bunion healing are diet, supplements and bone stimulators.  From a dietary standpoint it is important to incorporate lots of green leafy vegetables during the postoperative phase.  Supplements can play a role in healing as well.  One of my favorites is called ProBono.  This product provides all the minerals and nutrients for bone healing and helps to reduce time to heal.  Bone stimulators can be applied to stimulate bone growth.  These are harder to come by and often insurers will not approve these devices unless you have significant comorbidities.  If you have a bunion and would like to have it fixed and have the least amount of down time I can help. Give us a call at 425-391-8666 or make an appointment online today. 

Bunion xray

In the average week I see quite a few patients that are ready to finally have their bunion fixed.   The large majority of patients I have seen for years and their bunions are becoming bigger and more painful.  They are having a hard time fitting in shoes and going about daily activities.  The decision to fix their bunion is an exciting one and today's repairs of a bunion are much easier than in the past.

Fixing your bunion is a big decision and it can be overwhelming sometimes.  I really enjoy helping my patients through this process and eliminating the concern and apprehension around surgical correction.  Surgery for bunions has really come a long way and new techniques have created an almost foolproof approach.

The newest technique that I am really excited about is the Lapiplasty.  This is a great procedure that is reliable and has great long term results.  The Lapiplasty is excellent for patients that even have large bunions.  This procedure can be done in my office at our on-site surgery center.  This can provide huge time and cost savings. 

Do you have a bunion and have you always thought about fixing it?   Give me a call and I can help.  I look forward to fixing your bunion!!!! Give us a call at 425-391-8666 or make an appointment online today. 


Dr Brandon Nelson

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austin bunionectomy

Bunion surgery is one of the most common surgical procedures in the United States.  It is usually performed in an outpatient setting and no overnight stay is required.  The majority of bunion surgeries take less than 2 hours and have great long term outcomes.  The most common bunion surgery is an Austin bunionectomy as it is called. It has been utilized for almost 100 years and is a powerful tool in bunion correction. 

The Austin bunionectomy traditionally involved a cut in the 1st metatarsal head.  It was cut from medial to lateral in a chevron type fashion.  This allows for correction of the abnormally aligned joint and removal of the bunion.  It usually involves some sort of fixation to hold the bone in place like a screw or a pin.  Some surgeons require a period of non-weight bearing and typically 3 months before back to normal activities.`

I personally have performed this type of bunion surgery 1000’s of times.  I like to make a longer arm with my but on the bottom of the bone as opposed to a chevron style cut.  This allows for a more rigid fixation and faster recovery.  The typical patient can return to activities at 6 weeks. 

If you have a bunion that is causing pain and want to have minimal downtime give me a call and I can review all your options.  Remember I have an onsite surgery center that saves thousands as compared to having your procedure at a hospital or ASC.


Dr Brandon Nelson

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