bunion surgery in issaquah

Displaying items by tag: bunion surgery in issaquah

austin bunionectomy


Bunions can be quite painful and become a hindrance to everyday life.  While there are some conservative measures that may provide some temporary relief the only long term solution is surgery. 

First it is important to understand what a bunion is.  A bunion is when the 1st metatarsal shifts out of place.  This shifting gets worse with time and the bunion gets bigger.  The visual result is the big toe starts to overlap the 2nd toe and the protuberance you see at the base of the big toe is the 1st metatarsal.  To fix the bunion the 1st metatarsal needs to be realigned. 

The realignment of the 1st metatarsal can happen in two ways.  The first being you cut the bone and reposition it anatomically.  This is probably the most common bunionectomy performed in the United States.  It usually involves about 4-6 weeks in a walking boot and has great outcomes for smaller bunions.  The next most common would be a fusion of the tarsometatarsal joint.  This is a procedure that is for larger bunions or people with unstable foot structures.  This surgery usually requires a period of non-weight bearing for 3-6 weeks.  Both of these procedures can have great outcomes when utilized appropriately.

How do you know which bunion surgery is best for your foot?  There are many factors to take into account.  The overall foot structure, any other foot pathologies, lifestyle, recovery and age.  I recommend seeing a foot and ankle doctor that operates on a lot of bunions. 

If you have a bunion and would like a consultation I can help.  Please call 425-391-8666 or make an appointment online with Dr. Nelson.

Sincerely,

Brandon Nelson

Board Certified Physician & Surgeon

Issaquah’s Top Podiatrist & Foot/Ankle Surgeon

buniontreatments


Bunions are a common foot condition that can cause pain, discomfort, and difficulty with footwear. They typically develop when the joint at the base of the big toe becomes misaligned, leading to a bony bump on the side of the foot. Although surgical correction can provide relief for many individuals, some individuals may find that their bunions come back or reoccur over time. Understanding the factors that contribute to bunion recurrence can help individuals take steps to prevent this from happening.

1. Genetics and Foot Structure

One of the primary reasons bunions can reoccur is because of genetics and foot structure. Some individuals are predisposed to developing bunions because of inherited foot shapes or structural conditions. Even after surgical correction, the underlying foot structure is still there and may still contribute to the gradual return of the bunion over time. A perfect example this is a juvenile onset bunion. We see patients who are teenagers who already have quite pronounced bunions. In this case they certainly inherited foot structure that makes them highly prone to this. This is commonly due to an underlying foot structure called metatarsus adductus. Pronation is another foot structure that is prone to bunions. The combination can be especially challenging, a pronated foot with metatarsus adductus.

2. Improper Footwear

Wearing tight, pointed, or high-heeled shoes can exacerbate bunion formation and contribute to their recurrence. These types of footwear by raising the heel cause extra pressure on the entire forefoot and place excessive pressure on the toes and can force the big toe joint out of alignment. Even after surgery, if individuals continue wearing these type of shoes, it can increase the likelihood of bunions coming back.

3. Post-Surgical Care

Proper post-surgical care is critical for preventing bunion recurrence. Following your surgeon's instructions regarding activity levels, wearing orthotic devices or splints, and attending follow-up appointments is essential. Failure to adhere to post-operative care guidelines can increase the risk of the bunion returning.

4. Joint Instability

In some cases, joint instability can contribute to bunion recurrence. This may occur if the surgical correction did not adequately address underlying joint laxity or if there are other issues with the foot structure and foot biomechanics. Physical therapy and exercises to strengthen the foot and improve stability can be beneficial in these situations. Note that in example this would be a round first metatarsal head with laxity of the underlying capsule and ligaments.

5. Lifestyle Factors

Certain lifestyle factors, such as obesity or activities that place repetitive stress on the feet, can also contribute to bunion recurrence. Excess weight can put additional strain on the feet and exacerbate bunion formation. Similarly, activities that involve repeated bending or pressure on the toes can lead to joint misalignment over time.

6.

Surgical factors: when I see patients who come in for a 2nd opinion and have had surgery previously and there has been recurrence, I look to see how much correction was done initially. Sometimes there is a lack of adequate correction from the beginning and this creates a higher risk of recurrence. It is important to fully correct the bunion whenever possible. For example a juvenile onset bunion needs the most corrective surgery possible because they are so prone to reoccurrence. This often means a Lapiplasty or similar procedure. Another example would be a lack of adequate release of the soft tissue at the great toe joint. It is very important that after surgery the great toe joint lines up correctly and the big toe doesn't want to pull to the side toward the 2nd toe. If the soft tissue capsule is not adequately released this can be a problem.

Preventing Bunion Recurrence

While some factors contributing to bunion recurrence are beyond individual control, there are steps individuals can take to reduce the risk:

Choose Proper Footwear: Opt for shoes with a wide toe box, low heels, and adequate arch support to reduce pressure on the toes. Hold off on the really dressy shoes except for special occasion like a wedding or a special dinner out. And even then avoid a really high heel shoe.

Maintain a Healthy Weight: Maintaining a healthy weight can alleviate strain on the feet and joints.

Follow Post-Surgical Care Guidelines: Adhere to your surgeon's recommendations for post-operative care, including wearing orthotics and attending follow-up appointments.

Monitor Foot Health: Regularly check your feet for any signs of bunion recurrence or other foot issues, and seek medical attention if necessary.

Consider Conservative Treatments: In some cases, conservative treatments such as orthotics, padding, and physical therapy may help prevent bunion recurrence or delay its progression.

For those very high-risk patients using a "retainer" similar to a dental retainer can be used to help maintain the alignment of the great toe and keep it from drifting toward the 2nd toe or at least really slow its progression.

Make sure to discuss this concern if you are in for a surgical consultation. If you would like a 2nd opinion or have additional questions and would like consultation at our clinic, I would be happy to provide this consultation.

By understanding the factors that contribute to bunion recurrence and taking proactive measures, individuals can help reduce the likelihood of experiencing this common foot problem again in the future.


If you have any questions or would like a consultation please call 425-391-8666 and make an appointment online.

Dr. Timothy Young
Foot & Ankle Surgeon
Issaquah's Top Podiatrist


Bunions are often looked at as just a cosmetic concern however this is not true.  They can cause pain and discomfort and lead to more foot problems in the future.  Today I will discuss bunions, what they are, their cause, symptoms and what we can do to treat them.

What is a bunion?

A bunion is a bony protrusion of the 1st metatarsal.  It occurs as the 1st metatarsal shifts out of place and the big toe begins to drift towards the second.  This begins as a small misalignment of the joint and grows larger and more malaligned as time and mileage increase. 

Causes of bunions:

There are many causes of bunions and from long term research we know the following are the most common. 

-Genetics plays a large role in the development of a bunion.  You inherit your foot structure and this can predispose you to a bunion. 

-Another source cited is footwear.  Anything that puts more forefoot pressure like a high heeled shoe can accelerate bunion formation. 

-Systemic causes can be attributed to bunions.  Conditions like Rheumatoid arthritis or other arthropathies that attack joints. 

Symptoms:

These are what usually bring patients into the office.  These are things like having a hard time fitting shoes, rubbing the big toe on the 2nd toe.  Another common symptom is pain or swelling and redness of the big toe joint. 

Treatment:

I usually break the treatment up to conservative and surgical.  The conservative measures include, no bare feet and wearing a wider shoe.  Save your money no splints or stretching devices of the big toe work.  Remember this is a bony malalignment and you can not move bones from the outside of your foot.  Surgery is the only long term fix.  The surgical correction depends on the size, age and overall foot structure. 

If you have a bunion and would like a consultation I can help.  Please call 425-391-8666 or make an appointment online, and ask for an appointment with Dr Nelson.

Sincerely,

Brandon Nelson

Double Board Certified Physician & Surgeon

Issaquah’s Top Podiatrist & Foot/Ankle Surgeon

Bunion (1)


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 xray

Most bunion surgeries require screws or plates (or a combination). It’s important during bunion surgery, in order to get full correction and realign the bones and joints, the bone is typically resected or effusions are done to realign the first metatarsal.  This requires hardware such as plates and screws. Once the hardware has done his job and the bone has healed and maintained the new corrected alignment and position, many of our patients elect to have hardware removed. The hardware can be medical grade stainless steel or titanium. These are the most common metal/metallic implants used. 

Sometimes the head of the screw causes minor irritation or part of the threads protrudes enough that there is irritation with some of the adjacent soft tissue. 

In other instances some patients seem to be sensitive to having a foreign body or a non-human item in the body. Some patients have minor skin manifestations although this isn’t common.  In general patients feel better once the hardware is out. 

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

Bunion xray

Dr. Timothy Young
, Board-certified Foot Surgeon and Bunion Specialist, Talks About How to Heal Your Bones Faster After Bunion Surgery
Bunion correction surgery often involves resetting the bone or an osteotomy for bunion realignment. For more significant bunions there is often a fusion of the first metatarsal cuneiforms joint called a Lapidus procedure or Lapiplasy. For these cases it’s important to address both the soft tissue healing including the incision healing along with the underlying bone healing.

Bone healing can be addressed with variety of different measures including proper immobilization with the cast or a boot to keep weight off the area where the bone is healing. Bone healing stimulation devices, supplements that enhance bone healing such as ortho pro bono can help. If you are experiencing foot or ankle pain, give us a call today at 425-391-8666 or make an appointment online.

Bunion (1)

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. 

Thursday, 28 May 2020 22:53

Dr. Timothy Young Talks About Bunion Anatomy

Bunion xray

Most bunion problems involve an alignment issue with the underlying bones. The first metatarsal and the great toe become out of typical alignment. The joint itself become subluxed and is then prone to arthritis and adaptive changes.

Bunions can develop an early age. This is called juvenile onset. This involves the first metatarsal shifting away from the adjacent second metatarsal and the foot becomes wider.  In some cases this involves a splayfoot. Also there is more risk of bunion formation when there is underlying metatarsus adductus.  This is a genetic inherited foot structure.  It is common to see other family members that have a bunion. Often times you can look to let say your mother or grandmother and find that they also have a bunion, because of this genetic pattern.

Tight shoes can speed the process up and make things worse!  However, in general, you are born with a foot type that is prone to a bunion. 

If you have concerns about a bunion, give us a call at 425-391-8666 or make an appointment online! 

Dr. Timothy Young and Dr. Brandon Nelson.



Bunion surgery in the past was only performed in a hospital setting and patients often stayed the night at the hospital. Things have really changed and now patients do not stay the night in a hospital and most bunions are performed in a surgery center. The average bunion surgery takes less than 2 hours and patients will only require IV sedation as opposed to general sedation. This type of sedation makes for a much quicker recovery from anesthesia and often less side effects. I like to provide all my patients with a nerve block so they will get a good night's sleep the evening of surgery.  The majority of patients will be pain free the first night. 

The next day most patients will have pain that is well controlled with pain medication. Often patients will just take prescription pain medication for the first 24-48 hours and then switch to over the counter pain control.  We utilize advanced techniques that allow all our bunion patients to walk after surgery thereby minimizing down time and speeding recovery.  We have protocols to help get your ankle and toes moving right after surgery to decrease stiffness and swelling. Additionally, we will provide patients with exercise guidelines to help them stay fit and active during the recovery phase. One of the best aspects of our practice is we perform bunion surgery every single Monday and have fixed 1000’s of bunions.  Another enormous advantage of our clinic is an onsite surgery suite that will save patients thousands of dollars on the surgery as we have special discounted pricing compared to other doctors that must take you to a hospital or surgery center. Do not let your bunion keep your from wearing a normal shoe or enjoying the activities you love give us a call at 425-391-8666 or make an appointment online so we can help.

Bunion xray

What to expect after bunion surgery with your cast.
 
Bunion surgery typically involves realigning the first metatarsal. This may involve a Lapidus or Lapiplasty, which is in arthrodesis or fusion of the first metatarsal-cunieform joint. Bunion surgery may involve an osteotomy such as an Austin bunionectomy. This involves a bone cut in the head of the first metatarsal which is then realigned and re-positioned. After the arthrodesis or osteotomy it is important for the bone to heal properly. This requires several different factors. One factor is your casting or cast boot to protect that part of your foot as the bone is healing. It is best to put weight on other parts of the foot so that the stress load in the first metatarsal is reduced so that the bone can heal. 
 
With an Austin bunionectomy this can be accomplished with the cast boot or sometimes a surgical shoe. reliant junk removal
 
With the Lapidus or Lapiplasty we put you in a special cast that has a walking heel. This typically goes on between three and eight days after surgery. This allows you to put weight on your heel while protecting the front of the foot so that you can get around. The cast or cast bood should be continued until there is adequate bone healing. Typical bone healing can take between six and 10 weeks depending upon your status. People who smoke will always take longer to heal and may require additional considerations. Quitting smoking is always the ideal scenario.
 
Remember that after bunion surgery we want to maximize your soft tissue and bone healing to get you back to your normal activities as soon as possible.

If you have questions about bunion surgery we would be happy to see you at Issaquah Foot and Ankle Specialists. Either myself Dr. Timothy Young, or my partner Dr. Brandon Nelson.
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