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Bunion (1)

Bunions are often a painful condition especially when trying to fit certain shoes or exercise.  Let us first discuss what a bunion is then how we can relieve the pain. 

A bunion results from a combination of familial inheritance and environmental factors.  Meaning that if you do not have a genetic predisposition for a bunion, you will not create one by adding outside forces to your foot.    Where this becomes important for example is high heel shoes.  If you have a family history of bunions and you wear high heels you can accelerate the process of development of the bunion.  Or if you are an avid exerciser like a runner this can speed up the development of a bunion. 

So what is a bunion?  Well, there is a common misconception that a bunion is growth.  This is not true nothing grows with a bunion it is from a misaligned bone in the foot.  The culprit is the 1st metatarsal.  This bone begins to shift out of place and cause a bulge on the inside of the foot and continues to get worse until the big toe has rotated.  The bunion will get bigger as time goes on and often can begin to force the other toes out of position.  Bunions at this point become painful and hard to fit in shoes.

What can be done for bunion pain?  There are a lot of different things I can provide to relieve bunion pain.  It really requires an evaluation of the bunion.  But generally, wider shoes can help and prevent going barefoot.  There are other options that provide more relief, but it really depends on the stage of the bunion.

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

hammertoe

Hammer toes are a curling of the digits of the feet.  Specifically the middle of the toes bend downwards and from the side looks similar to a hammer.  There are other digital deformities as well like claw toes and mallet toes.   But today we will just discuss hammer toes. 

Most of the time it is an inherited foot structure that causes hammer toes.  An example of this is a flatfoot.  A person is born with a flat foot and over time the tendons that run to the toes have been working to create an arch for so long the toes permanently deform creating a hammer toe.  There are other causes but the number one cause is the flexor tendons on the bottom of the toe overpowering the other tendons.  Once the tendon imbalance occurs hammer toes are the results. 

There are a few options for treatment of hammer toes.  It is based upon the flexibility of the hammer toe.  Is the hammer toe flexible or rigid?   If the hammer toe is flexible you can release a tendon and the toe will lay flat.  However if the hammer toe is rigid you must remove a small piece of bone in order to get correction.  I also recommend looking at the foot structure that is influencing the hammer toe and correct that as well. 

If you have hammer toes and would like to discuss how I can help make an appointment with me today.  Give us a call at 425-391-8666 or make an appointment online today.

Sincerely, Dr. Brandon Nelson 

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.

Sincerely,
Dr. Brandon Nelson 

heel pain out of bed in the morning

Heel pain and heel spur syndrome are painful conditions that can affect everyday life and make walking and exercise miserable.  I see patients that have been suffering for years from this and have tried to live with it.  I encourage anybody with heel pain or bone spurs to seek help earlier as it is much easier to rectify this situation with early intervention. 

Heel pain is often caused by plantar fasciitis.  The plantar fascia is a large thick band of connective tissue that helps to hold up the arch.  It is activated when you walk or exercise to provide dynamic control of the foot.   It can become extremely painful with overuse and create a considerable cycle of pain.  Usually, the pain is worse in the morning, then gets a little better as the day goes on but returns anytime you sit down or rest.  Currently there are many great treatment options for fasciitis, however the underlying cause needs to be identified. 

Heel spur syndrome often occurs with plantar fasciitis.  This is when a bone spur develops on the heel bone or calcaneus.  It is often on the site where the plantar fascia attaches and can be a result of long-term tension from the fascia.  It can be difficult to determine if it is the bone spur or the fascia that is inflamed.  Both can be present at the same time and often testing is needed to differentiate the sources of pain. 

I understand that heel pain can be life altering and am here to help. 

If you have heel pain, and want to get back to enjoying your life, make an appointment with me today at 425-391-8666 or book an appointment online

Dr. Brandon Nelson
Issaquah Foot and Ankle Specialists

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

Bunion (1)

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 straightforward 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. 

Should I fix my bunion?

I think the answer to this question is does it hurt or do you have a hard time fitting in shoes or doing the activities you enjoy because of the bunion?  Most people with a bunion at some point will answer yes to this question and that is a good time to think about fixing it.  The other consideration is do other parts of my foot hurt because of the bunion or are my toes changing position because of my bunion?  Again if this is happening now maybe the time to fix it.

Is Surgery going to hurt?

Yes, surgery is going to be uncomfortable.  However, we work very closely with our post-operative patients to make sure their pain is well controlled during recovery.  It is imperative that patients get a head of the pain and take all medications that are prescribed.

How long does it take to recover?

This is a harder question to answer.  There are many factors that lead to recovery but in general.  Some patients are walking on their feet immediately and some must wait weeks.  The return to shoe can be as early as 4 weeks or longer like 10-12 weeks.  Most sports or activities have no limitation at 3 months.  

Does bunion surgery need to be done at the hospital?

A lot of surgeons still use the hospital or outpatient surgery center for bunion surgery.  These facilities can be very expensive.  My practice has a surgical suite which saves large amounts of money and time for every patient.  

 

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

Sincerely,Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Screenshot 2023 07 12 at 9.08.19 AM

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.

Sincerely,
Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Screenshot 2023 07 12 at 8.53.43 AM

Bunion surgery is one of the most common procedures done in the United States.  It is recommended most of these are done in an outpatient setting and patients can go home the same day.  Most procedures are done in about 2 hrs and patients can walk in a protective boot.  Most bunion procedures involve cutting bone or realigning joints. 

Since bone is cut it is important to take calcium or a bone healing supplement.  These can help decrease healing time and make recovery much easier.  Additionally, I like my patients to use a bone stimulator and remain home for the first couple days.  Sacrificing a little time on the front end of the surgery can make recovery much easier.  Another supplement like collagen can help with skin healing and provide better scar appearance.   

The vast majority of bunion surgeries can be done in our office.  A mild anesthetic and a little bit of local anesthetic will provide enough comfort to sleep right through the procedure.  Having it done in our office setting, in a sterile environment, provides large cost savings and time savings for patients. 

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

Sincerely,
Dr Brandon Nelson

American College of Foot & Ankle Surgeons

Screenshot 2023 06 28 at 11.25.52 AM

Dr Timothy Young, a board certified foot surgeon talks about Reversing a Bunion: Understanding the Causes, Treatment Options, and Prevention Part 2

Surgical Intervention:

Bunionectomy: In some cases where conservative treatments are not effective, a bunionectomy may be necessary. This surgical procedure involves realigning the affected structures and bones to correct the deformity. The specific surgical technique used will depend on the severity and complexity of the bunion.

Preventive Measures:

It is often not possible to prevent bunions however, certain measures can help slow down their progression or reduce the likelihood of developing them:

a. Footwear choices: Look for shoes that provide extra room for the toes, have a wide toe box, and have good arch support.

b. Avoid high heeled shoes: Wearing high-heeled shoes can exacerbate existing bunions or increase the risk of developing them.

c. Maintain a healthy weight: Excess body weight can put extra pressure on the feet, potentially worsening bunions.

d. Exercises and stretches: Regular foot exercises and stretches can help strengthen the muscles and improve flexibility.

Dr. Young's Postoperative Swelling Tips

Conclusion:

Reversing a bunion involves a comprehensive approach combining conservative treatments, such as good footwear and orthotic devices, with surgical treatments if necessary. Early preventive measures are helpful steps in treating bunions effectively. If you are experiencing foot pain or notice a bunion forming, please contact our clinic.  We specialize in bunion treatments.

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

Screenshot 2023 06 28 at 11.19.29 AM

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

Introduction:

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.

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