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austin bunionectomy


Bunion surgery continues to be one of the most common surgical procedures performed in the United States.  In the United States approximately 150,000 are operated on annually.  The satisfaction and success rate are high, and most patients are happy with their outcomes.

It is important be well prepared for bunion surgery and I will discuss a few tips that will make the process easier.

1.     Make sure you are prepared before the day of surgery and have somebody to help for the first 24 hours

2.     Set up a central command, ie a bed downstairs that you have all your necessary items near.  Your medications, a bathroom, and some entertainment.

3.     Bathroom - you may want to investigate a booster seat for your toilet. It can be difficult if it is too low to stand up once seated.

4.     Shower, consider a shower chair or stool

5.     Cast cover of something to keep your leg dry

6.     Vitamin supplements, I like collagen and bone healing supplements

7.     Understand your post-operative course

8.     Icing - do not underestimate the importance of icing and elevation for the first 72 hours. 

9.     Exercise to prevent blood clot, ankle rotations, leg lifts.

I hope you find some of these tips helpful. If you are experiencing foot or ankle pain, give us a call today at 425-391-8666 or make an appointment online

Sincerely,

Dr Brandon Nelson

austin bunionectomy

Bunion surgery
is the most common type of surgery I perform.  I really enjoy correcting bunions and the outcome can be very satisfying for both the patient and physician.  There are many types of bunion procedures that can be executed.  Procedure selection is based on the size of the bunion, the patient and overall foot structure.  It is important to have an overall foot exam and an x-ray.

One of the most common procedures done today is the Lapiplasty.  This procedure has the ability to correct the bunion in the 3 different cardinal planes.  Motion of the foot occurs in 3-D and correction for the bunion sometimes requires looking at these.  It should be noted not all bunions require this. The most important factor in good outcomes is careful attention to the correction itself and the foot structure.

Lapiplasty for me has provided excellent outcomes and continues to be very popular among my patients.  I like the reproducibility of it and it has the ability to correct large bunions.  The long term outcomes are great as well and patients have a high satisfaction with the overall procedure. 

Consultations: I currently am accepting patients for evaluation and management of their bunions.  I will provide patients with x-rays and a diagnostic workup as well as both conservative and surgical options.  If you have a bunion and would like to be evaluated please call my office at 425-391-8666.

Sincerely,
Double Board Certified 

austin bunionectomy

Bunion surgery
is by far the most common procedure I do on a weekly basis. It is a very satisfying procedure for patients and can lead to great outcomes. I have now been operating for the last 15 years and have completed 1000’s of bunion surgeries and the Lapiplasty has shown great promise.

With bunion surgeries I like to see the technique to be reliable and reproducible. Additionally, I like a procedure that is versatile and can correct bunions of all sizes. The Lapiplasty seems to meet all these criteria and is seeing a large increase in execution.

I have personally been utilizing this procedure since I was a resident. It has been the work horse of my toolbox and continues to be. The Lapidus procedure provides predictable outcomes and has a very low reoccurrence rate. It is especially useful for pediatric patients and large bunions.

The Lapiplasty is a patented system that makes the Lapidus bunion procedure easier for the surgeon to execute. It is a specific set of instruments that helps the surgeon. I think this system will continue to evolve and help us surgeons to have great outcomes. If you have a bunion and would like a consultation please contact my office today and I will be happy to review all your options as is pertains to bunions and bunion surgery.

Sincerely,

Dr. Brandon Nelson

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Dr. Timothy Young
, a Board Certified Foot Surgeon Discusses Sesamoid Problems – Part 2

Problems with the sesamoid bones in the foot can be an overuse injury.  As mentioned previously, some sports have higher association of sesamoid problems,  such as dance.  The injury and damage to the bones can range from inflammation of the soft tissue around the sesamoid bone and capsule.  We call this sesamoiditis.  Further damage could lead to fracture of the bones and this is often readily seen on an x-ray.  The problem is that some individuals have sesamoids that, are as 2 separate bones or portions from birth (congenitally)  

Therefore, it can be difficult to determine if it is a fracture or if it is a structural congenital condition.  This is called a bipartite sesamoid when it is a congenital structural condition with 2 separate bones.  Additional problems may include damage to the blood supply of the bone or avascular necrosis.  This can be difficult to diagnose and often requires an MRI.  A typical office based examination would include x-ray evaluation of the sesamoid bones.  As mentioned this can clearly diagnose many fractures or arthritic conditions of the sesamoid bones.  More subtle changes can be seen with ultrasound imaging.  And as mentioned, an MRI is very useful for sesamoiditis especially if there is concern over potential avascular necrosis.

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


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Dr. Timothy Young
 a board certified foot surgeon, discusses treating midfoot arthritis.
Midfoot arthritis is a common problem, especially as we all get older. Very commonly it the second metatarsal–cuneiform joint Is involved. Often additional adjacent joints can be involved. There are a number of treatments for this condition that can range from prescription orthotics, rocker style shoes, calf stretching and nutritional supplements. Additional treatment options include injections of synthetic joint lubricant into these joints.

This can be a difficult access or find the correct entry point, therefore we use ultrasound guidance to verify correct placement of the synthetic join lubricant. There is some communication between these adjacent midfoot articulations or joints and therefore there is additional benefit by injecting the second metatarsal–cuneiform joint to some of the adjacent communicating joints.  We typically use Supartz which is a highly purified form of hyaluronic acid.  I typically use the same protocol for other joints such as the ankle joint which is a series of injections at 1 to 2 week intervals usually 3 to 5 injections. 

If you are experiencing foot or ankle pain, give us a call today at 425-391-8666 or make an appointment online today. 
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Dr. Timothy Young
 a board certified foot surgeon discusses how to enhance results of hallux limitus surgery with a cheilectomy.
For early to moderate stage hallux limitus with degenerative joint disease and adaptive changes of the great toe joint, a common procedure is a cheilectomy. During this procedure, the bone spurs or osteophytes are removed and additional bone is removed from the dorsal or top of the first metatarsal head.
In addition, during the surgery the joint fluid is flushed out of the joint space. This is joint fluid that is produced by of the synovial lining of the joint. After the surgery is done additional joint fluid will replenish this loss of joint fluid.  We can augment this process. We commonly add synthetic joint lubricant to the joint early during the postoperative period. We currently use Supartz Hauluronic acid to enhance our results after surgery. This facilitates early range of motion and, also has a protective effect on the cartilage. In addition, ultrasound guidance is used to verify the correct position and placement of the Supartz directly into the joint. Early physical therapy can be beneficial also. 

If you have arthritis of your great toe joint or questions about potential surgery or procedures for this please request a consultation at our clinic. Give us a call today at 425-391-8666 or make an appointment online today. 


Bunion xray


Bunion surgery
is probably the most common procedure I execute.  Most bunions can be fixed in about 2 hours and provide great long-term results.  The most important factor is to have a thorough workup and x-rays to evaluate the foot.  Once the foot and x-rays have been done then a plan for surgical or conservative care can be formulated. 

If surgical intervention is called for, our office has an onsite surgery center which can save the average patient thousands of dollars as compared to free standing ASC’s or the Hospital.  Our certified surgery center provides the best possible patient experience and has been functioning for over 15 years.  If you have a bunion and have been contemplating what to do, I can help.  I really enjoy helping people with bunions.  Please make an appointment and we can discuss your options. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr. Brandon Nelson

Bunion xray

The Lapiplasty technique has created an effective tool for bunion surgery.  The foot and ankle surgeon community has seen a reproducible tool that has helped revolutionize bunion surgery.  This procedure has helped bunion surgeons get the best possible correction with incredible long term outcomes.  The Lapiplasty combines a tried-and-true bunion surgery technique with modern jigs and fixation.  Bunion surgery is challenging and any tools that can help with getting better outcomes are looked upon favorably.  This is the case for the Lapiplasty system. 

As a Board-Certified Surgeon and Physician and somebody that has done 1000’s of bunion surgeries, this is a welcomed tool in my armamentarium.  I have found that Lapiplasty is a game changer.  I find my results are outstanding and long lasting.  I look forward to helping more patients with bunion recover faster and returning earlier to activities is a giant plus! If you suffer from bunion pain come see if you are a candidate for Lapiplasty. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr. Brandon Nelson

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Dr. Timothy Young, a Board Certified foot surgeon, discusses collagen supplements after surgery.
We have discussed at length supplements and the role with bone healing.  Today we're going to discuss supplements and tendon and soft tissue healing. Tendons are made of collagen. Many structures in the body have collagen skin hair nails and even bone.  Tendons especially have a very high collagen content.  Supplemental collagen is recommended, and for example 6000 mg per day total of the youtheory tablets is a good starting dose (3000 mg twice a day) .  

For example Achilles tendon surgery or repair of an Achilles tendon rupture.  Peroneal or posterior tibial tendon surgery.  In addition zinc (25 mg up to 50 mg per day) and boron  (3 mg per day) are supplements the can be helpful with deep tissue healing and wound healing.  It's important to note that zinc can compete with some other essential elements such as calcium and magnesium so it's best to take zinc by itself for example at lunchtime.  Remember there are always things that you can do to help your body heal.

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

Bunion (1)

We know that bunions are an inherited trait that can be exacerbated by activities and shoe gear.  Patients can have a bunion on the inside or outside of their foot.  The typical bunion is on the inside of the foot and involves the 1st metatarsal while the bunion on the outside of the foot involves the 5th metatarsal.  Either pathology can often require surgical intervention in order to provide long term relief and the primary surgery is usually the bunion on the 1st metatarsal.  The bunion will usually dictate the recovery and the bunion on the 5th metatarsal usually heals faster.

Bunions are typically fixed in a few ways, either a surgery at the head of the metatarsal or the base of the metatarsal.  It is important to get an x-ray to examine the overall foot structure to make sure there are no other driving forces that need to be fixed.  The typical foot structure we see with a bunion on both sides is a flat foot that has progressed with time.  The foot often widens when a flatfoot is present to try and create more stability.  The flatfoot may or may not need to be addressed.

Most bunion surgery patients will be walking the entire time after surgery and can continue with modified exercise.  I utilize techniques that allow my patients to be more active and recover faster.  It takes years and hundreds of patients to perfect these techniques and dealing with athletes has allowed an advantage to improve on outcomes.  If you are having bunion pain please make an appointment and I will see how we can best help you. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr. Brandon Nelson

Board Certified Surgeon & Physician

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