Brad Schaeffer, DPM, is a board-certified foot surgeon with the American Board of Foot & Ankle Surgery who is well-known for his appearances on the hit TLC show, 

 He attended Temple University School of Podiatric Medicine before completing a residency program focused on comprehensive foot and ankle reconstructive surgery at Hoboken University Medical Center. He has since continued his training and crafted his skillset in cutting edge surgical techniques and regenerative medicine.

To make an appointment with Schaeffer, visit 

Brad Schaeffer, DPM

Hallux valgus, more informally known as a bunion, is an incredibly common condition that impacts almost 25% of American adults.

Though bunions are often recognized by patients as a large bump on the side of the big toe, they are far more complicated internally. The deformity occurs due to bones in the mid-foot sliding out of alignment and can lead to a marked decrease in quality of life, including debilitating pain and loss of physical activity.

Bunion prevalence increases with age, even though any person can develop them regardless of lifestyle.

Recognizing this prevalence is especially important in the case of patient safety, as bunions are associated with a decrease in gait and balance and are considered an independent risk factor for falls in 

Initial recommendations from physicians typically consist of nonsurgical interventions, including changes to footwear, usage of medication to help manage pain, icing the affected area, and even padding and usage of specialized soles. If nonsurgical approaches fail to alleviate pain and discomfort, a patient suffering from bunions may require surgery.

For both patients and physicians alike, surgery is often seen as a last resort due to long recovery processes and highly variable outcomes associated with treatment options of the past.

 In addition, increased age is linked to a greater risk of surgical complications due to higher rates of comorbidities and longer recovery times. However, advancements in medical technology have expanded surgical options for older patients suffering from bunions.

Some procedures address the root cause of bunions through tri-plane correction, correcting foot deformities in the sagittal, coronal, and transverse planes.

 In the case of severe bunions, some surgeons opt to utilize tri-planar first tarsometatarsal (TMT) arthrodesis, where the joint is fused to help provide stability, improve cosmetic appearance, and correct the deformity. Traditional Lapidus fusion, in comparison, also involves fusion of the first tarsometatarsal joint, but does not take all 3 planes into account. Multiple studies found that patients who underwent the triplanar-first TMT arthrodesis procedure had recurrence rates between 1-3%.

 While reducing rates of recurrence is beneficial to all patients, it is imperative for older adults to minimize elective surgeries, when possible

In the case of older patients with less severe bunions, particularly those at higher risk of surgical complications, minimally invasive surgeries (MIS) may be considered a more suitable option. The principles of tri-planar correction have been applied to metatarsal osteotomy, where the bone is cut and realigned. Because the incisions made are smaller, there may be a reduced chance of scarring and a faster recovery time, with most patients being able to return to their daily activities within approximately 4 months post-operation.

Geriatric patients suffering from bunions have more options in the case that surgical intervention is needed. Expanded treatment paradigms and improvements to minimally invasive techniques have made surgery more accessible for older adults suffering from adverse changes to their lifestyles. These advancements may help contribute to maintaining mobility and independence in the aging population.

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https://www.webmd.com/skin-problems-and-treatments/understanding-bunions-basics

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Liu GT, Chhabra A, Dayton MJ, et al. One- and Two-Year Analysis of a Five-Year Prospective Multicenter Study Assessing Radiographic and Patient-Reported Outcomes Following Triplanar First Tarsometatarsal Arthrodesis With Early Weightbearing for Symptomatic Hallux Valgus. 

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Articles

Hallux valgus, or bunions, affect nearly 25% of American adults, with prevalence increasing with age. This condition, characterized by a misalignment of mid-foot bones, can significantly impair quality of life and increase fall risk in older adults. Initial treatments are nonsurgical, but surgery may be necessary if these fail. Recent advancements in surgical techniques, including tri-planar correction and minimally invasive surgeries, have improved outcomes and accessibility for older patients. These innovations help maintain mobility and independence, especially in geriatric populations with severe or less severe bunions.

Discover effective treatments for bunions in older adults, including advanced surgical options and minimally invasive techniques to enhance mobility and quality of life.