A bunion is a common foot condition I see at my clinic.  It is amazing the different sizes and shapes of bunions I have seen during my career.  There are a couple of things I have noted during this time.  One is that the bunion gets bigger.  It does not grow but the bone continues to move out of alignment.  Secondly it is easier to fix earlier in the process especially when the other toes are not involved.  Lastly, the most important aspect is proper procedure selection.  This leads me to my discussion today.  The Lapiplasty has really revolutionized bunion surgery.

I was listening to a lecture today and they were discussing the fact that there are over 150 different types of bunion surgery.  Most of these techniques are no longer utilized.  But this is important because it illustrates how difficult it can be to get long term corrections.  This is why I am a fan of the Lapiplasty procedure.  The Lapiplasty corrects the bunion at its apex.  It helps to realign the bone in all 3 cardinals planes that the body moves in.  It has helped surgeons to provide the best correction for the patient and speed recovery.  I find this procedure has incredible outcomes and my patients are happy with their results. 

If you are suffering from a bunion I can help.  I have seen how painful and debilitating these can be.  Make an appointment online or give us a call at 425-391-8666

Sincerely,

Dr Brandon Nelson

American College of Foot & Ankle Surgeons

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. 

Bunion surgery is one of the most common surgical procedures in the United States.  It is usually performed in an outpatient setting and no overnight stay is required.  The majority of bunion surgeries take less than 2 hours and have great long term outcomes.  The most common bunion surgery is an Austin bunionectomy as it is called. It has been utilized for almost 100 years and is a powerful tool in bunion correction. 

The Austin bunionectomy traditionally involved a cut in the 1^st metatarsal head.  It was cut from medial to lateral in a chevron type fashion.  This allows for correction of the abnormally aligned joint and removal of the bunion.  It usually involves some sort of fixation to hold the bone in place like a screw or a pin.  Some surgeons require a period of non-weight bearing and typically 3 months before back to normal activities.`

I personally have performed this type of bunion surgery 1000’s of times.  I like to make a longer arm with my but on the bottom of the bone as opposed to a chevron style cut.  This allows for a more rigid fixation and faster recovery.  The typical patient can return to activities at 6 weeks. 

If you have a bunion that is causing pain and want to have minimal downtime give me a call and I can review all your options.  Remember I have an onsite surgery center that saves thousands as compared to having your procedure at a hospital or ASC.

Sincerely,

Dr Brandon Nelson

I have been operating on bunions now for over 15 years and have performed 1000’s of bunionectomies.  I continue to enjoy working on bunions as the surgical results are satisfying for both the patient and physician.  Bunions come in all sizes and present in all ages from teenagers to adults.  Many patients seek out care for bunions and some choose to have them fixed.  It is important to note that not everyone is a surgical candidate and not every bunion requires surgical intervention. 

Surgical care for a bunion can provide excellent results.  One of the most common procedures is the Lapiplasty bunionectomy.  It has shown exceptional follow up and long term outcomes.  I find the Lapiplasty to be very reproducible and have high patient satisfaction.  It is not appropriate on every patient nor is it the only bunion procedure I find highly successful.  

My office has an onsite surgical center that we utilize for bunion surgery.  It is a significant cost savings and time savings for patients.  It utilizes monitored anesthesia care with a nerve block of the lower extremity.  If you have a bunion and would like a consultation please feel free to call the office at 425-391-8666 or schedule an appointment online.

Sincerely,

Dr Brandon Nelson

Dr Brandon Nelson, A Board Certified Physician and Surgeon, Discusses the American College of Foot and Ankle Surgeons Consensus on Bunions

This month the American College of Foot and Ankle Surgeons released an updated version of statements regarding bunion deformities.  It was released to look at the best available evidence, clinical practice, and clinical experience to treat bunions.  As a member and Board-Certified Surgeon, I feel it is an essential tool to have in our clinical practice.  I will summarize some of the important findings:

1.     The bunion is a deformity that should be considered chronic, progressive, and degenerative in nature.  

2.     The juvenile bunion should be evaluated and managed differently than the adult.   

3.     Effective assessment and evaluation require and x-ray.

4.     Procedural decision making for bunions should address the specific anatomy of the deformity.

5.     Bunions should always be addressed with joint preserving procedures when appropriate.

This is a main summary of what was stated.  Bunions continue to be a difficult pathology for patients.  If you have bunion pain I am happy to help come up with a treatment plan. Give us a call at 425-391-8666 or make an appointment online today. 

Sincerely,

Dr. Brandon Nelson

Bunions are by far the most common surgical procedure I perform.  At this point in my career after practicing more than 10 years, I have performed thousands of bunion procedures.  Bunion surgery itself is a highly successful procedure that has great outcomes and patient satisfaction.

The 3-D bunion correction or lapiplasty is a great tool that has accelerated the bunion surgery techniques.  I find the procedure itself can be easily reproducible and has great long-term success.  This is a great tool for large bunions and for patients that have had long-standing bunion deformities.  It is important to see somebody but has experience performing this technique, because there are some technical challenges.

The Lapidus or lapiplasty is a most common bunion procedure I perform and I have found it to be extremely powerful surgical tool.  If you have a long-standing bunion deformity and have had pain and irritation and are contemplating surgical reconstruction please make an appointment.  I will happily review your x-rays and possible surgical options.

Sincerely,

Brandon Nelson

Board-certified Foot and Ankle Physician and Surgeon

Bunion pain is a common presentation at my clinic.  We see a large percentage of bunion patients wanting consultations for surgery.  Bunion surgery is highly successful and moderate techniques provide decrease healing times and decreased postoperative pain.  It is important to understand that there are many different types of bunion surgery that can be performed.  The primary indicator for bunion surgery selection is the overall foot structure and the size of the bunion.

Over the years I have seen many different types of bunion surgery come in and out of favor.  It is important to realize there are a few procedures that have been around for years and continue to be the work courses of bunion surgery.  The most common bunion surgery performed in the United States is was called a head procedure or an Austin type bunionectomy.

The Austin bunionectomy involves repairing of the small some medium size bunion.  It consists of cutting the first metatarsal head in a Chevron type fashion and then moving the head in a lateral position towards the fifth metatarsal.  Additionally some bone is typically shaved off the medial aspect or the inside of the first metatarsal head and some soft tissue is released laterally.  This is a great procedure provides wonderful correction in the majority of patients are able to fully walk after this procedure.

If you have bunion pain and are interested in having a surgical consultation please make an appointment today or give us a call at 425-391-8666 and I’ll happily help get it fixed. 

Sincerely,

Dr. Brandon Nelson

Board-certified American College of Foot and Ankle Surgeons

Board-certified American Board of Podiatric Medicine

Bunions we know are primarily a hereditary foot structure issue. What I mean by that is the foot structure or foot alignment is what causes the bunion. You inherit your foot from your family genetics and often the foot type you inherit may lead to a bunion. There is usually a family history of bunions, and this can often skip generations. There is a portion of the bunion as well that can be exacerbated by environmental factors. Shoe gear, i.e high heels can put more pressure on the front of your foot increasing bunion formation. Other factors include things like exercise or really anything that increases foot pressures. Even injury and trauma have been associated with bunion development. The bunion is a complex pathology that has both generic and environmental factors that lead to its formation.

Pain, pain is by far the most common reason people come to the doctor. The most frequents spots for bunion pain are right near the knuckle of the big toe or under the 2nd toe. The knuckle of the big toe, or technically the first metatarsal head begins to protrude out and cause pressure with shoe gear. This gets worse with time as the bunion gets bigger. The 2nd metatarsal or 2nd toe becomes painful as the bunion gets bigger and the foot less stable.

If you have a bunion and would like to schedule a consultation, call 425-391-8666 or make an appointment online. 

What is a bunion?

A bunion is a genetically inherited foot structure that leads to migration of your 1st metatarsal. The bunion itself is where the 1st metatarsal begins to protrude out the medial or inside of the foot. Nothing actually grows or forms new bone, but it is the deviation of the normal bone that creates the bunion. The bunion can continue to rotate and get larger until it creates hammer toes of the other digits. The bunion eventually causes pain and deformity that needs to be addressed surgically.

Bunion surgery:

One of the most common bunion surgeries is a head procedure. This involves cutting the metatarsal bunion and the end closest to the toe. The bone is then shifted back into place and held with a screw. This procedure works well for mild to moderate bunions and has a fairly quick recovery. The patient can walk the entire time and return to activities much sooner than other procedures.

Outcomes:

The typical bunion surgery has a 5% recurrence rate. The majority of the bunions that return are from not following post-op instructions or other foot factors. It is important to have your surgeon address all other components of your foot and procedure selection should be based on these findings. An x-ray is vital for procedure planning and an overall foot exam to help determine what other pathologies are present.

If you are suffering from bunion pain make an appointment today and I can help you get back to the activities you enjoy!

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