podiatrist issaquah
Displaying items by tag: podiatrist issaquah
Dr. Timothy Young Discusses Bunion Surgeries Part 3
.jpg)
Dr. Timothy Young Discusses Bunion Surgeries Part 3
After the surgery Dr. Young likes to keep close tabs on his patients' and their recovery. It is important that any post procedure pain is well-controlled. It is also important that they have proper instructions beforehand, so they are prepared at home when all the anesthetic wears off. This is where being a couch potato pays off. Keeping the feet elevated, using ice, and taking medication as prescribed is critical. It is also critical to protect the surgical site either using a special boot, splint, crutches, or scooter. All the presurgical advice like getting a shower protector keeping the dressing intact to protect the surgical site comes into play. At each postoperative visit, the surgical site is checked to make certain it is healing properly and that there are no signs of infection.
Post acute recovery involves:
This involves bone remodeling and healing and soft tissue remodeling and healing. Sutures are removed. Post procedure x-rays are taken to verify the correction is maintained and that the bones are starting to bridge together properly. Our patients take special bone healing supplements also. We also often work with outside physical therapy clinics to help our patients heal faster and obtain proper range of motion and strength.
In conclusion, preparing for bunion surgery requires a comprehensive approach that considers the patient’s medical history, the extent of the deformity, and the type of surgery required. A skilled surgeon will carefully plan the surgery, provide detailed instructions for pre- and post-operative care, and closely monitor the patient’s recovery to ensure the best possible outcome.
If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today.
Dr Timothy Young Discusses Bunion Surgeries
Dr Timothy Young Discusses Bunion Surgeries in Detail, Part 1
Bunion surgery is a common procedure performed by Dr Timothy Young and other Foot Surgeons to correct a bunion deformity. A bunion is usually combination of the first metatarsal being out of alignment and bony bump that forms on the joint at the base of the big toe. This can cause pain and discomfort when walking or wearing shoes. The bunion correction surgery itself usually takes 1-2 hours. The surgeon’s preparation for bunion surgery requires planning ahead and, requires attention to detail. In this blog, we will go over the steps that Dr. Young and other foot surgeons take to prepare for the best bunion treatment and the best bunion surgery.
Patient Evaluation
Before any bunion surgery, Dr. Young will evaluate the patient's medical history, medications, and overall health to make sure that our patients are good surgical candidates. Dr. Young will also examine the patient's foot to determine the severity of the bunion, the extent of the deformity, and the type of bunion surgery that would be most appropriate. For example, some patients have a severe bunion deformity and require a Lapidus or Lapiplasty procedure. Some patients have extreme adaptation of the great toe joint and require a procedure that realigns the joint. Some bunions are mild and yet the joint is not flexible and for this, decompressing the joint is an effective treatment. These evaluations come from both physically examining the foot, and imaging evaluation.
Imaging Tests
The surgeon will typically order imaging tests such as X-rays, CT scans, or MRI scans to get a better understanding of the bunion’s structure and position. This information will help the surgeon plan the surgery and determine the best approach to correcting the deformity. Dr. Young uses digital x-rays which allow for precise measurements and preoperative planning that can be done right on the computer.
Anesthesia Planning
Dr. Young will discuss the anesthesia options before surgery. Dr. Young often utilizes local anesthetic combined with MAC anesthesia (monitored anesthesia with conscious sedation). Other options include general anesthesia, regional anesthesia, or local anesthesia. The type of anesthesia can be discussed prior to surgery and will depend upon the patient's medical history and the type of foot surgery and the extent of bunion surgery. With MAC anesthesia combined with local anesthetic, the patient is still conscious and breathing on their own (not intubated). This is more like a twilight sleep and the patient's recovery extremely fast, and we can avoid the typical side effects that can be encountered with the general anesthetic.
The preoperative visit:
Dr. Young's patients come in the week prior to surgery to help them prepare for surgery. We will discuss details of the surgery itself and how to care for the foot after bunion surgery and if crutches or a special boot will be required. Also, the patient's medical history and medications are reviewed. Some medications will be avoided prior to surgery. Usually, the patient will be required to fast prior to surgery and need to make driving arrangements after the procedure. Our patients are given a special antibacterial scrub to do at home prior to surgery.
If you are experiencing foor or ankle pain, give us a call at 425-391-8666 or make an appointment online.
Dr Brandon Nelson, A Board-Certified Physician & Surgeon Discusses Everything You Need To Know About Your Bunion
Bunions are primarily a genetic foot structure that is inherited from mom or dad. We see that it can skip generations as well. There seems to be a misconception that the bunion is just a growth on the side of the foot. However, this is not true. The bunion is a misalignment of the first metatarsal. It occurs when the first metatarsal separates or begins to deviate from the second metatarsal towards the other foot. This in turn causes the big toe to deviate or point towards the second digit. The growth or bump that one sees is the first metatarsal pointing out of the joint. This concept is important to understand as it will make sense when I discuss bunion correction.
Bunion correction refers to removal or reversal of the bunion. Well now that you understand it is a deviation, more correctly a progressive deviation of the first metatarsal, you can see why certain things will not correct a bunion. I have seen all sorts of strapping, taping and splinting techniques to correct a bunion. Now that it is clear this is a movement of a bone you can clearly see why none of this works. It is not possible to move the first metatarsal back into place once it has deviated via any sort of appliance or device you apply to the outside of the foot. Once the bone has moved the only option to correct the bunion is surgical.
Surgical correction of the bunion is the only way to reverse this misalignment. This is the only avenue we have to bring the big toe back into the correct orientation. There are many different techniques based on the size of the bunion and the rest of the foot structure. If you have a bunion and need help please schedule an appointment. Give us a call at 425-391-8666 or make an appointment online today.
Sincerely,
Dr Brandon Nelson, A Board Certified Physician & Surgeon, Discusses Achilles Tendonitis
Many athletes will suffer from the dreaded Achilles tendonitis. Increased training and often a change in activities can precipitate this pathology. It is quite frustrating and can sideline many active patients. I personally have dealt with this issue and can understand the challenges associated with it.
The Achilles tendon is the main unit in the lower extremity for the push off phase of gait. It contracts and helps individuals with forward motion. It is constantly under load and being utilized with every step. It is a wonder that more people don’t suffer from tendonitis.
The main cause continues to be overuse. It often is seen in runners and joggers and triathletes. In my office, runners seem to suffer from it. Runners seem to have the biggest demand on this tendon and overuse is quite easy. However, they are not the only one’s, basketball players seem to be affected as well. Probably related to the loading requirements of jumping. Regardless of the causes, it is important to seek help early in the process.
Early intervention seems to be the key in recovering from Achilles tendonitis. I also encourage stretching to all my athletes. It is an easy thing to skip as it is time consuming and we can be pinched for time. Additionally, hydration is essential and I find collagen supplements to be beneficial as well. If you have any signs or symptoms do not delay. I can help get you back out participating in your favorite activities. If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today.
Sincerely,
Dr Brandon Nelson, A Board Certified Physician & Surgeon, Discusses Healing From Bunion Surgery
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.
Dr Brandon Nelson, A Board Certified Physician & Surgeon, Discuss Heel Pain
Heel pain can usually be broken down into a few main causes. The first and most common is plantar fasciitis. This is usually pain right at the bottom of the heel bone towards the inside arch. The second most common cause is Achilles tendonitis. This pain is more found towards the back of the heel. Lastly there is a condition called Baxter’s neuritis that can cause burning in the foot. This pain is usually on the inside of the foot.
Plantar fasciitis is by far the most common cause of heel pain. It is typically seen in adults between the ages of 40-60. Typical symptoms are pain in the morning or pain after rest. It is often an overuse type injury. Plantar fasciitis can usually be treated successfully and the protocol I use keeps people exercising for the duration of treatment.
Achilles tendonitis usually presents with swelling near its insertion towards the back of the heel. Sometimes a catching or popping can be felt. This is also another pathology associated with overuse. I cannot stress enough that this should be evaluated immediately.
Baxter’s neuritis is a little trickier. This condition usually presents as a burning in the heel but can mimic plantar fasciitis. I usually see this in conjunction with plantar fasciitis. This pathology usually requires special testing to identify.
If you have heel pain I can help. I think this is some of the most frustrating injuries to deal with especially for the people that are training. If you are experiencing heel pain, give us a call at 425-391-8666 or make an appointment online today.
Sincerely,
Dr Brandon Nelson
Dr. Timothy Young, a Board-Certified Foot Surgeon, Discusses Children's Foot Problems
This attachment point can be overstressed with a pronated low arch foot structure. Basically the tendon has to work too hard and there can be pain and inflammation with the tendon attaches to the navicular. In other cases the tendon attaches to the accessory navicular bone which then attaches to the main navicular bone. This weakens the attachment point and creates more potential problems. In some cases, the accessory navicular has to be removed. This foot surgery procedure is called a Kidner procedure and is done at approximate 13 years of age with a range of 9 to 16 years of age for children. This is sometimes done in adults also. When the accessory bone is removed and the tendon is repaired it often improves the mechanical function of the tendon at this point. It also eliminates the inflamed and symptomatic accessory bone. The accessory navicular very common and is present in approximately 5-10% of the population. For milder cases, ankle braces orthotics and athletic taping can all offer some symptomatic and functional improvement with the painful accessory navicular.
If you or your children are experiencing foot or ankle pain, give us a call today at 425-391-8666 or make an appointment online today.
Dr. Timothy Young, Board-Certified Foot Surgeon, Discusses Painful Bumps and Bones That Stick Out on Children's Feet
Dr. Timothy Young, Board-Certified Foot Surgeon, Discusses Painful Bumps and Bones That Stick Out on Children's Feet
Up to 10% of the population may have this. Also the navicular bone itself even without the extra or accessory bone may be quite prominent. This is much more of a problem in children that have low arches/hyperpronation or flat feet. The posterior tibial tendon that attaches this location is at a strong mechanical disadvantage. On the outside or lateral aspect of the foot there may be a tailors bunion or bunionnette. And a smaller percentage of the pediatric population will have a growth plate or and apophysis of the 5th metatarsal base. This is called Iselin's disease. We will go over each of these more detail in some of our following blogs and discussion.
If you are experiencing foot or ankle pain, give us a call today at 425-391-8666 or make an appointment online today.
Dr Brandon Nelson, A Board Certified Physician & Surgeon, Finds the Lapiplasty Surgical Procedure for Bunions to be Highly Successful
I have been operating on bunions now for over 15 years and have seen all sizes and shapes of bunions. It is interesting to see the techniques that have come in and out of favor. I have had an opportunity to watch as the Lapiplasty has moved to the forefront of surgical procedures for bunion correction. I believe this is a great option for bunion repair and am excited to see what the future holds in regard to the Lapiplasty.
I find the Lapiplasy highly successful for large bunions or patients with flatfeet. The Lapiplasty provides great correction and faster recovery. It is an easily reproducible procedure with gigs and guides to help with correction. It provides for stable fixation and allows for early weight bearing. It can be used at all ages and helps to maintain long term correction. The system is revolutionary for surgeons and has taken years to develop.
I can say I am excited to continue using this system and to help my patients with bunions. It is wonderful to have a tool set like the Lapiplasty at my surgery center and to help so many patients walk normally again. If you have been contemplating bunion correction I would love to share this exciting new technology with you. Give us a call today at 425-391-8666 or make an appointment online today.
Sincerely,
Dr. Timothy Young, a Board-Certified Foot Surgeon, Discusses Insertional Achilles Tendon Problems
Dr. Timothy Young, a Board-Certified Foot Surgeon, Discusses Insertional Achilles Tendon Problems
Especially very large areas of calcification with men. Although women can get a condition that similar but different called a Haglund deformity. In this case it is the bone on the posterior aspect of the calcaneus that protrudes and can be aggravated by the adjacent Achilles tendon and not intratendon calcification. In the early stages this is very treatable. As time goes on and there are large areas of calcification, they can cause chronic problems. As I mentioned, in the early stages this response to some of the classic treatments for Achilles problems. That means a special brace, orthotics to decrease the workload and side to side mechanical shearing of the tendon at the insertion point, calf stretching and related treatments, and shockwave therapy. The later stages the same treatments are often still helpful, but they may not offer full relief. These are the individuals that often require surgery. The surgery involves access to the back of the Achilles insertion point with removal of the calcific portions and then reattachment of the tendon itself. The healing process for this can be similar to an Achilles rupture. There are new anchors that help to give more reliable surgical reattachment of the Achilles to the underlying bone.
If you are experiencing foot or ankle pain, give us a call at 425-391-8666 or make an appointment online today.
