Bunions are one of the most common reasons people schedule an appointment with a foot and ankle surgeon.  It is by far the most common surgical procedure I do.  People of all ages and activity levels can have a bunion.  The primary reason people schedule an appointment is difficulty fitting the shoes they would like to wear.

I think there are quite a few reasons to fix your bunions these days and I will discuss a few of the most beneficial reasons.

1.     Foot Structure

Bunions are an inherited foot disorder and are more common in women.  They are usually the result of a foot that wants to flatten out too much or what we would call pronate.  A bunion results when the first metatarsal tries to stabilize the medial arch.  This results in the first metatarsal moving out of place and the bunion developing.  Fixing a bunion can result in stabilization of the medial arch.  This can have effects on the overall stability of the foot.  I see patients that have had plantar fasciitis or other stability issues that resolve once the bunion is fixed. 

2.     Shoe Fit

Another big issue with bunions becomes an inability to fit in normal shoes.  I see a lot of wide shoes and short extra depth shoes when people try to accommodate bunions and other toe deformities.  It is often a relief to be able to have shoes fit again and get back to wearing the shoes you once enjoyed or liked after your toe is straightened. 

3.     Your Bunion Will Get Larger

Many people believe they can use straps or tape or toe straighteners and change their bunion.  However, we know from long term data this is not true.  There is no way to reverse your bunion without surgery.  Everyone’s bunion with time and mileage will get bigger.  I recommend having it fixed before it causes the 2^nd toe to become a hammer toe or begins to cross over or under the 2^nd toe.

If you have a bunion and want an evaluation schedule an appointment with me, or make an appointment online, I will help you. 

Sincerely,

Brandon Nelson

Board Certified Physician & Surgeon

Issaquah’s Top Podiatrist & Foot/Ankle Surgeon

Bunions are painful deformities that are common and can cause pain and discomfort daily.  Surgery for bunions has been around for over 100 years but recent advancements have made bunion surgery easier than ever.  Today we will discuss the Lapiplasty bunion procedure, its advantages and how it has changed the way we correct bunions. 

What is a bunion?

A bunion is an inherited foot issue that involves the deviation of a bone in your foot.  Specifically the 1^st metatarsal begins to drift in the wrong direction making it difficult to fit shoes and can be quite painful.  Genetics play a big role in the development of a bunion and things like shoe gear can contribute to the bunion. 

Lapiplasty procedure

Convention bunion surgery often involves cutting the bone and realigning a joint.  This type of procedure has been utilized for years and is still the most popular bunion surgery in the world.  It has its applications and is appropriate for certain individuals.  The Lapidus or Lapiplasty focuses on larger bunions and people that have a more unstable foot.  It aims to correct the bunion in a more comprehensive approach and provides the best long term results.

It involves correcting the bunion in 3 planes, realigning the metatarsal, correcting the bunion at the root cause.  The joint where the bunion originates is cut and realigned and fixated to heal in the proper position.  Recovery can vary by patient and bone quality same with healing times.  I do recommend physical therapy and follow up is essential.

In conclusion Lapiplasty has revolutionized bunion correction and provides excellent long term results and is by far the best procedure for many patients.    

If you would like a consultation for your bunion I can help.  Call to make an appointment with me at 425-391-8666 or make an appointment online.

Sincerely,

Dr Brandon Nelson

American College of Foot & Ankle Surgeons

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

Bunions are present in many different sizes and shapes.  I see bunions on the inside of the foot, the outside of the foot and both.  It is important to remember that some small ones can be painful, and some large ones can be pain free.  It often seems to be dependent upon activity levels and shoe gear.  If they hurt or limit your lifestyle then maybe it is time to fix them. 

Fixing your bunion

Bunion surgery has two main procedures that are done.  One is what is called a head procedure.  This is basically cutting the bone and realigning it through transposition of the bone.  Usually fixated with one or two screws.  The other involves fusion of a joint, specifically the joint that is involved with the creation of the bunion.  This procedure is called a Lapidus bunionectomy. 

Bunion recovery

Recovery really depends on the procedure that is performed.  Head procedures recover faster and usually involve no periods of non-weight bearing.  The fusions often involve a period of crutches or knee scooters.  This can be as short as 3 weeks or as long as 10 weeks.  The weight bearing status can be dictated by other procedures that are done as well. 

Which bunion surgery is right for me?

This is a hard question to answer.  I believe this is where your consultation with your surgeon is extremely important.  Other factors like lifestyle, recovery support, expectations and experience can play a major role.  I think it is important to get an entire overview of the process and have a discussion with your surgeon.   

If you would like a consultation for your bunion I can help.  Call to make an appointment with me at 425-391-8666 or make an appointment online.

Sincerely,

Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Bunion surgery is one of the most common surgeries performed in the United States.  It is something like 250,000 operations annually, that is a lot of bunions!  Well, how can you maximize your results, get back to activities early and heal faster?  I will give you some insight on these questions.    

Maximizing bunion results, when I think about what this question means I think it would pertain to how you get the best outcomes.  This means to me how you make the foot more functional and get a good cosmetic result.  This would be best done through appropriate procedure selection.  There are a lot of different bunion operations that are used to fix different sizes of bunions and different foot structures.  To me the most important thing here is to select a bunion surgeon that does a lot of bunions. 

How do you get back to activities earlier?  The main point here is to follow your surgeon's protocol.  Do not listen to your neighbor or friend, they might have had a different operation than you.  Your surgeon really knows best in this case.  Most of us have taken years to perfect our post-op protocol and do not deviate from following them to the letter.  But if you have questions or concerns ask to let us know.

Healing faster can mean a lot of things, the skin, the bone, when one can walk.    The skin is the first thing to heal. I always recommend collagen and zinc supplements.  These seem to speed things along and once the incision is closed there are some great products to minimize scar appearance.  Next is the bone, a good bone healing supplement is essential and if available a bone stimulator can shave weeks off healing.  Weight bearing is a different story, often this depends on other procedures that were done.  I try to get all my patients moving and bearing weight within a couple days if appropriate.  The minimum is to start a range of motion exercises.    

If you would like a consultation on your bunion, I can help.  Call to make an appointment with me at 425-391-8666 or schedule an appointment online. 

Sincerely,

Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Bunion surgery is the most common surgical procedure I perform at my ambulatory surgery center.  I have a few tips I would like to share that can make things much easier.

Get ready a week before surgery.  Start thinking about where you will set up.  I always recommend being a couch potato for about a week.  This home base spot should be conveniently located.  This spot should be downstairs and near a restroom.  Make sure you have access to anything that might pass the time, a computer, tv, etc. 

Meals are another thing to think about.  I like to advise my patients to make a weeks’ worth of food.  You can freeze them or refrigerate them but not having to cook can be a game changer.  This can really help you focus on your recovery, and nobody wants to cook with a sore foot.

Supplements are another thing to consider.  I think talking to your surgeon about this one is important.  Calcium or some sort of bone healing supplement if you are having bone work done.  Collagen and zinc can help wound healing.  Once the wound closes, start topical scar care.

The bathroom situation can need some thought as well.  How will you shower or use the toilet?  I always if you are going to be non-weight bearing to have a trial run of both.  It can be difficult executing these tasks with one foot.  Options for these include a shower chair or stool and for the toilet they make elevated seats that are helpful.

Medications are the last thing I will touch on.  Get these before the day of your procedure.  Think about making a log or schedule so you can track what and when you take them.  Make sure you understand what each is and that you have no interactions with other medications you are taking. 

If you would like a consultation on your bunion, I can help.  Call to make an appointment with me at 425-391-8666 or schedule an appointment online. 

Sincerely,

Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Dr Timothy Young Discusses What to Expect After Lapiplasty Bunion Surgery: Road to Recovery

Introduction

Bunions, those painful bony bumps that form at the base of the big toe, can be incredibly uncomfortable and limit your mobility. For those who have chosen to undergo bunion surgery to alleviate the pain and discomfort, it's important to be well-prepared for what comes next. In this blog, we'll discuss what to expect after bunion surgery including Lapiplasty bunion surgery and provide insights into the recovery process to help you make the journey as smooth as possible.

Day of Surgery

1. Arrival at the Surgery Center: On the day of your surgery, you'll arrive at the surgery center, where you will be prepped for the procedure. The medical team will ensure you're comfortable and informed about the process.

Anesthesia: Bunion surgery is typically performed under local anesthesia with sedation. You'll discuss this with your surgeon before the procedure.

The Surgical Procedure: The surgery usually takes approximately 2 hours, depending on the complexity. The surgeon will make incisions, remove the bunion, and realign the toe joint. With the Lapiplasty procedure there will be 2 plates. With some the other Lapidus procedures there may be 2 or possibly 3 screws.

Recovery Timeline

1. Post-Operative Recovery Room: After the surgery, you'll spend some time in the recovery, where the medical staff will monitor your vital signs and ensure you're comfortable.

Returning Home: Most patients return home on the same day of surgery.

The First Weeks After Surgery

1. Pain Management: Expect some pain and discomfort, which is normal after bunion surgery. Your surgeon will prescribe pain medication to help manage this. Follow their instructions carefully.

Swelling and Bruising: Swelling and bruising are common. You can use ice packs and elevate your foot to reduce swelling.

Dressings and Bandages: You will have a dressing on your foot to protect the incision. Keep it clean and dry. Your surgeon will give you instructions on when to change the dressings.

2. Weight-bearing timeline. This varies from patient to patient.

First 2 weeks with the Lapiplasty typically you are using a scooter or crutches and keeping weight off.

Week number 3 – 6 you progressively bear weight with your boot.

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

Dr Brandon Nelson, Discusses the Lapiplasty Procedure for The Best Possible Correction of a Bunion

Bunions can be quite painful for people especially as they get larger and make it difficult to fit in shoes.  Bunions tend to get bigger as time goes on and eventually push the other toes out of alignment.  But what can be done to stop the bunion or even slow it down?

Many people want to know what can be done from a conservative standpoint to slow a bunion.  I have seen all sorts of devices to pull the toes around to try and straighten a bunion.  But, it should be known that the bunion is a bony pathology that is related to a change in position of the bone.  This makes it impossible to apply something to the outside of the foot to fix a bone on the inside.  However, there are a few things that can slow down a bunion.  Most important is to understand a bunion gets larger the more pressure that is exerted on it. 

Meaning the more you walk the bigger the bunion gets.  This is where conservative therapy begins.  The best now measure to intervene here is a prescription orthotic for bunion correction.  I am not talking about an insert from a shoe store or online this must be done by a physician.  This is a prescription medical device where biomechanical measurements and 3-D measurements of the foot are taken.  The good news about this is most insurances cover this device as long as it is prescribed by your foot and ankle physician. 

Surgical correction is the ultimate stop gate to the bunion getting bigger.  There are many options for surgical correction but the one moving to the forefront of medicine today is the Lapiplasty.  This procedure is based upon the Lapidus which has been utilized for almost 100 years.  This is a tried and true method for getting amazing bunion correction and providing lasting results.  If you have a bunion I can help.  Give me a call at 425-391-8666 or make an appointment online today.

Sincerely,

Dr Brandon Nelson

Bunion surgery has been around for over 100 years.  Historically, there were about 120 different types of bunion surgeries that could be performed.  This has changed over the years as long-term data became available and we could see different outcomes with different procedures.  This has shaped bunion surgery and now there are only about 4 commonly used procedures in the United States with 2 of the 4 being the most popular.

The first one is called an Austin bunionectomy.  This procedure is executed at the head of the 1^st metatarsal.  It involved cutting the bone and realigning the joint.  It is usually secured with 1 or 2 screws.  Most patients can walk on this in a boot following surgery.  The average time to heal is typically 4-8 weeks.  This procedure is primarily reserved for smaller bunions.  It is the most popular bunion procedure done to date.

However, some of us surgeons that do a lot of bunion surgery have been utilizing a procedure called the Lapidus bunionectomy.  It is a little more technically challenging but has better long-term outcomes.  This type of bunion correction holds up the best and is best for people with large bunions or young children.  Recently Treace Medical has come out with a system to make the Lapidus easier and more reproducible for surgeons.  This system is called Lapiplasty.  I have found it can be helpful and is getting a lot of traction in health care currently. 

If you have 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

Bunion surgery has been utilized for more than 100 years.  Recent advances in bunion surgery have created better outcomes and faster recoveries.  I have been practicing now for 15 years and have not seen such a revolutionary product come to the market before.  The lapiplasy system has changed bunion surgery for the better.

Lapiplasty has created a unique set of instruments to create reproducible outcomes.  Previously surgeons relied on resecting bone without the use of cutting guides.  The Lapiplasty system has guides and reduction clamps to get the same amount of correction every time.  This has changed long-term results, making them more reliable with time. 

Recovery has also changed.  In the past patients could be non-weight bearing for up to 8-10 weeks.  This new system often allows patients to bear weight at 2-4 weeks.  Bearing weight sooner allows for improved function and less atrophy.  

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 or contact us online. 

Sincerely,

Dr Brandon Nelson

American College of Foot & Ankle Surgeons