bunion surgery

Displaying items by tag: bunion surgery

Bunion xray


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 1st 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

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 (1)

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

bunionsurgery

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

Bunion (1)

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

surgery circle

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 1st 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 (1)


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

Screenshot 2023 09 04 at 10.25.26 AM

Surgery in general can be an overwhelming endeavor.  There are often a lot of new instructions, medications, and appointments to keep track of.  I have a few recommendations that can be helpful for anybody undergoing bunion surgery

One of the first things to do is make a list.  I love it when my patients show up with a list of questions at their pre-op appointment.  This helps to make sure all topics are covered, and nothing is a mystery come surgery day.  In that list often is a shopping list is helpful things like bandages, supplements, otc medications and healthy foods.

Getting a base of operation set up before surgery can help with easing the recovery.  I recommend a place on the 1st floor if you have multiple levels.  Somewhere that is close to the bathroom and is relatively quiet to aid in recovery.  Ideally you have room for your post-op supplies nearby.  It is also nice to have something in the room to help pass the time like a TV or music.

Personal hygiene is another area to touch on.  I find it helpful for my patients to have some sort of stool to sit on in the shower.  This helps reduce pressure on the operated foot.  Additionally, if you are non-weight, bearing a toilet seat can be helpful.  Practice, practice, and practice have some dry runs of showering and using the toilet before surgery to see if you need any other items.  I think it is trickier than most of us remember to be off one foot. 

Lastly a few miscellaneous tips;

1.    Couch potato for the first 72 hours.

2.    Elevating makes a big difference in long term swelling.

3.    Take any recommended supplements.

4.    Do not change the dressings unless instructed.

5.    Lots of fluids.

6.    Take a stool softener.

I hope these were helpful.  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

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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