Here at the Washington Bunion Center, Dr. Brandon Nelson and Dr. Timothy Young, one of our biggest goals during the postoperative healing phase is to do everything possible to speed-up the healing process, and especially the bone healing process. This starts out by effective protection for the foot and ankle and leg during this timeframe. Initially the patient is in a splint. Then we placed the patient in the special fiberglass cast. The fiberglass cast typically will have a walking heel as far back as possible. This allows for full weightbearing on the heel without any pressure in the forefoot. To make this more comfortable for the patient we will split the fiberglass cast (bivalve) and tape the seems. This allows for better access for physical therapy and for bathing. This special fiberglass cast has been fine-tuned in our clinic to make our patient’s as comfortable as possible and to help maximize healing. Another component for healing is the bone healing itself. It is critical to take supplements to help maximize bone healing. This includes calcium and vitamin D magnesium and vitamin K 2. We recommend Orthotic Pro Bono supplement and it is available at our clinic for our patients. In addition to the supplements, there is some studies the taking arginine supplements can be beneficial. Some of our patient’s may require a bone stimulation unit also. There are several different technologies available. One utilizes a pulsed ultrasound unit (Exogen), and the other major technology utilizes a pulsed electronegative magnetic field (PEMF). To summarize, proper bone healing during the postoperative phase of bunion surgery includes proper immobilization, nutrition, and even physiology such as bone stimulation units. Here at the Washington Bunion Center, for both Dr. Brandon Nelson and Dr. Timothy Young, our goal is to speed up the postoperative bone healing so that our patients can fully and quickly recover from bunion surgery.

The Bellevue Bunions Center specializes in treating patients with painful bunion conditions. Not all bunions are the same. Some bunions will require surgical intervention while others will get by with conservative care measures. Surgical care for bunions usually consists of a procedure done at the head of the base of the first metatarsal. The size of the bunion, the nature and the pain often determine what procedure is appropriate. An experienced bunion surgeon is extremely important to produce good outcomes. Dr. Nelson and Dr. Young have been performing bunion surgery for more than 15 years and have performed thousands of procedures. We have created unique treatment protocols that we can offer for conservative care that alleviate the most painful bunion deformities.

This patient presented to the office with a bone cyst in the calcaneus.  The patient was very active and enjoyed numerous sporting activities.  The first xray reveals a large cyst in the calcaneus.  The majority of  these cysts are unicameral or aneurysmal bone cysts.  This type of cyst can be a source of heel pain or aching in the foot.

• Lateral preoperative xray revealing large cyst in the calcaneus.

The patient was taken to the operating room and the large cyst was identified, removed and packed with bone chips.

• Intraoperative fluroscopic image after the cyst has been removed and packed with bone grafting material.

The patient healed uneventfully and has returned to full participation in activities with no limitations.

• The cyst has been completely removed and is filling in nicely with new bone. 

Many people tend to postpone addressing painful conditions with their feet or ankles. Often, people believe that pain in their feet is just something they have to live with. Perhaps the most common complaint of our patients with persistent pain is bunions.

Bunions are generally progressive and the pain also increases with time. Many people wait too long to address the issue and continue to wear improperly fitting footwear that increases the sensitivity. When the pain becomes significant enough patients seek our treatment.

Non-surgical treatments are preferred by both doctor and patient, however as the bunion continues to progress untreated non-surgical treatments become less effective. If a bunion disorder progresses to the point when surgery is needed, what are the options?

Bunion surgery is an ambulatory procedure. This means that the procedure is performed in an outpatient setting (we perform these in our own ambulatory surgery center located in our office) and typically takes an hour or two to perform the surgery.

Initial evaluation including x-rays and a gait analysis will be performed. The surgery is typically performed with a local anesthesia and either Arthroplasty or Osteotomy is performed. These procedures will reshape or cut the protrusion and typically titanium screws are inserted. The surgical screws will hold the bones in the new corrected position and provide long term stability to the area.

The surgery in painless with minimal discomfort the during recovery period, which is treated with over the counter pain relievers. Dependent upon the severity and degree of correction, many patients are back on their feet in a few days.

What can be done to avoid surgery for my bunions?

Non-surgical bunion treatments mostly attempt to mitigate the pain associated with bunions. These include changing your footwear and specifically avoiding narrow or pointed shoes. Padding and taping will provide some cushion to the area and may reduce friction, swelling and sensitivity. Orthotics or shoe inserts can provide relief. Over the counter shoe inserts can be helpful, however the best orthotics are custom made, prescription orthotics. These prescription orthotics are made specifically to address your unique issues that many of the over the counter orthotics cannot address.

• Did you know that every time you lift your heels, you are forcing your to carry half your total weight?
• One of your feet is probably bigger than the other one! It's rare for both feet to be the same size.
• Smoking cigarettes is the leading cause of Peripheral Vascular Disease (disease of the arteries of the feet).
• On an average day, your feet produces hundreds of tons of force, the equivalent of a cement truck!
• Walking is probably the most ideal exercise for your feet. It helps you improve circulation and also helps you control your weight.
• Three out of four Americans will have foot problems at one point in their lives. 
• On average, people will walk 115,000 miles in their lifetime -- that's more than 4 times the circumference of Earth!
• One out of every four bones in your body are found in your feet!

• Keep your body fit. Exercise is the key to being healthy.

• Maintain a healthy body weight. People who are overweight often suffer from foot and ankle conditions caused by too much pressure.

• It's good to exercise, but don't overdo it. Too much exercise can give your feet problems.

• Always warm up before and after exercising to get your body ready for the physical activity.

• Stretch your feet in the mornings. This will help reduce tension.

• See a podiatrist if you are experiencing pain for more than a few days!