Modern Day Bunion Correction
A bunion, or hallux valgus, is a bump that appears in the middle of the great toe, but it is the result of an unstable joint in the middle of the foot. This unstable joint called the first tarsometatarsal joint, or TMT, causes the metatarsal bone to deviate toward the midline of the body, creating a painful bump. This forces the great toe to move toward the lesser toes.
Bunions are a common foot problem that affects people of all ages. Often, they respond to conservative treatments, but if you regularly experience foot pain, don’t wait to seek professional help, fix it right the first time with Lapiplasty 3D bunion correction. At North Florida Foot & Ankle Specialists, Joshua Epstein, DPM, AACFAS, FACPM, and Sarina Epstein, DPM, AACFAS, are specifically trained in the innovative Lapiplasty 3D correction system. They are pleased to be among a select few practitioners selected to provide this service and are the only providers in both Gainesville and Lake City, Florida to offer this comprehensive care for bunions. To make an appointment at the office in Gainesville or Lake City, Florida, call the nearest office today.
Fix It Right The First Time With The Lapiplasty Procedure
Bunions are not simply a growth of bone that can be removed to cure the condition. Traditionally, surgeons just shaved off the bump to provide extra relief in tight shoes. As technology and skills advanced, surgeons, progressed to cutting the metatarsal near the great toe joint, moving the bone over to straighten the great toe. This cutting of the bone is called an osteotomy. This technique is how most bunions are corrected today. This traditional procedure does not address the unstable foundation that caused the bunion to form. It also does not address the rotation that is part of the majority of bunions and therefore does not restore normal function of the joint. Studies report a 12X increased risk of recurrence of the bunion compared to Lapiplasty 3D correction.
87% of all bunions are misaligned in 3 dimensions.
12x likelihood of recurrence if the 3D deformity is not addressed.
Up to 70%
Up to 70% of osteotomy patients experience recurrence over time.
1 in 3
1 in 3 patients are dissatisfied after 2D bunion surgery.
What is Lapiplasty
The Lapiplasty procedure is an improvement upon a procedure called a Lapidus bunionectomy, which was designed to reduce the complications with traditional surgery.
Most large bunions today are repaired with the Lapidus technique. The source of the deformity, the unstable 1st TMT joint, is reduced and fused together with a single metal plate or two screws. This two dimensional repair allows for more long-term results compared to just cutting the metatarsal, but it has several pitfall.
Lapiplasty improves upon the Lapidus procedure by reducing the abnormal 1st TMT joint and its associated metatarsal precisely, utilizing a specialized, patented reduction clamp. The rotation of the metatarsal is most importantly reduced to normal alignment, allowing the great toe joint normal comfortable motion. The misaligned joint tissue is then resected with a patented cutting guide before fixating the joint. This ensures perfect cuts and reduces surgeon air when cutting the bone.
Two small titanium plates and eight titanium screws are then used to fuse the joint in its natural position. The patented two-plate construction provides improved stability to the joint during the recovery process, eliminating the need for casting after surgery, instead allowing the patient to wear a walking boot. This two-plate construct is like holding a basketball with two hands versus one hand.
The Lapiplasty Difference
Lapiplasty has improved upon the traditional bunion osteotomy and Lapidus procedure in several significant ways.
1. Deformity Reduction
The deformity is reduced in three dimensions, allowing a return to normal function of the big toe joint.
2. Improved Fusion
The rate of non-healing of the fusion side is less than 3% with Lapiplasty, compared to 10% with traditional Lapidus procedures.
3. Early Weight Bearing
No cast is required. Patients can start to apply weight to their foot in a boot in just days after surgery.
4. Reduced Recurrence
Recurrence rate of the bunion with Lapiplasty is less than 3% where traditional osteotomy surgery can have up to a 70% recurrence rate.
5. Reproducible & Predictable
Patented cutting guides and clamps are used to fix the unique deformity present allowing for precise correction every time.
Recovery with Lapiplasty surgery
The surgery is performed in a hospital or surgery center under general anesthesia and can be completed by a Lapiplasty trained surgeon in approximately one hour. Patients go home the same day of surgery in a walking boot and mostly stay off of their foot for three days but are permitted heel touch weight-bearing to get around the house. They use a scooter or roll about, on which they kneel for three days and continue to use for long distances for up to 4 to 6 weeks after surgery as it makes movements much easier than traditional crutches.
At three days after surgery heel, touch weight-bearing is allowed in a walking boot for short distances.
Stitches are removed in 10 to 14 days after surgery, and patients can begin applying more pressure to the foot so that by four weeks post-op, they can walk in a boot without the assistance of a walker or crutches. By six weeks after surgery, patients transition to athletic shoes.
Aggressive activity, like running, can begin about three months post-op, but low-impact exercise is allowed once out of the walking boot and is comfortable in normal shoe gear.
Am I a surgical candidate?
Any patient who suffers from pain from a bunion, inability to wear shoes comfortably, or limitation to activity that affects their quality of life is a candidate. This procedure is also approved for children who suffer from bunion pain.
The choice is clear – don’t settle for the procedure your grandmother had for her bunions, the future of bunion surgery is here, and it is called Lapiplasty 3D bunion correction!
NFFAS’s surgeons are proud to be part of a group of limited surgeons specially trained to offer this procedure to their patients. We hope to see you soon!
Bunions Q and A
A bunion is a hard, bony bump that forms on the outer edge of your foot at the base of your big toe. It occurs when the bones at the front of your foot become misaligned, pushing the bone at the bottom of your big toe outward.
Bunions are a progressive disorder, meaning they develop slowly over an extended period. Anyone can experience a bunion, but they’re especially common in people who wear tight shoes that push the toes together.
What are the symptoms of bunions?
Symptoms of bunions include:
- Pain or stiffness
- Inflammation and redness
- A burning sensation
As the bunion gets bigger, you might also experience difficulty bending your toe or putting weight on your affected foot.
What causes bunions?
Most bunions occur due to an inherited structural abnormality. For example, if you’re born with flat feet, or you have an unusual gait, you’re more likely to experience a bunion.
The type of shoes you wear can also increase your risk of a bunion. If you wear shoes without an adequate toe box, it can affect the alignment of the bones in your feet.
How are bunions diagnosed?
To diagnose a bunion, North Florida Foot & Ankle Specialists review your medical history and ask about your symptoms, including their severity and if any activities like standing or wearing a specific pair of shoes make them worse.
Next, your provider carefully examines your foot, looking for signs of a visible bony bump. They might also order a series of X-rays to assess the severity and to determine the type of treatment that benefits you most.
How are bunions treated?
North Florida Foot & Ankle Specialists typically recommend non-surgical treatment to manage bunions. For example, you might benefit from:
- Wearing more comfortable shoes
- Bunion pads
- Activity modification
- Over-the-counter medication
- Custom orthotics
- Corticosteroid injections