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,
Board Certified Physician & Surgeon
Issaquah’s Top Podiatrist & Foot/Ankle Surgeon
