New procedure treats the root cause of bunion deformity

Podiatrist Dale Brink, DPM,* of Performance Foot and Ankle, achieved a first for the South Suburbs in 2017 when he successfully performed a revolutionary new approach to traditional bunion surgery called the Lapiplasty bunionectomy at UChicago Medicine Ingalls Memorial Hospital.

Two years later and dozens of Lapiplasty procedures completed, Brink continues to perfect his technique and is involved with nationwide efforts to improve the surgery.

The Lapiplasty procedure corrects the root cause of bunions — a misaligned toe bone — while dramatically shortening the time patients have to wait to bear weight on the affected foot. The technique is a new approach to a traditional Lapidus bunionectomy.

“Contrary to popular belief, bunions are often complex deformities that stem from joint issues in the mid-foot,” Brink said. "The root cause of a bunion is an unstable joint at the base of the foundation of the metatarsal bone."

With an unbalanced foundation, the bone leans out of alignment and creates a bump on the side of the foot at the base of the big toe. Most bunion treatments only address the top part of the metatarsal and ignore the real problem: the unstable joint.

“A common misconception is that a bunion is simply an overgrowth of bone that can be ‘shaved’ off,” Brink said. During an osteotomy or Lapidus bunionectomy, the surgeon cuts and shifts the top part of the bone over, treating the bunion symptoms or bump.

“An osteotomy is a two-dimensional solution for a three-dimensional problem,” Brink said. With the unstable joint still at its foundation, the underlying cause of the bunion deformity isn’t addressed and, as a result, is prone to return. The Lapiplasty procedure, however, addresses the root of the problem.

“Using advanced instrumentation, the entire metatarsal bone is corrected in all three dimensions, restoring it to its proper alignment while naturally removing the bump and straightening the toe,” Brink added. “The unstable joint is then fused with titanium plates, which permanently secure the correction in place. Although recurrences can still happen, the Lapiplasty dramatically reduces the risk of recurrence.”

Since the procedure uses advanced fixation technology, many patients are able to bear weight on their foot within days after surgery — much less than the six weeks after a traditional bunionectomy. Also, footwear choices and physical activity aren't limited after a Lapiplasty.

"With the procedure at Ingalls, we have achieved the Lapiplasty Center of Excellence designation as a high volume center in Illinois," Brink said.

Cherlyn Plaia, a 74-year-old who works as a crossing guard in Thornton, decided to get the Lapiplasty procedure on her left foot when her painful bunion prevented her from walking for more than 30 minutes at a time. She also was finding it more and more difficult to spend a lot of time on her feet.

“I’m turning 75 next year, and I’ve always wanted to go to the Canadian Rockies," Plaia said. "I knew I needed to have my foot worked on to walk during my trip."

Plaia experienced very little pain after surgery. The most difficult part, she said, was maneuvering with a walker for a short time before transitioning to a walking boot.

“I’m ecstatic that I had the surgery done, and I was very pleased with my physical therapy experience in South Holland,” Plaia said. “Dr. Brink is a super guy.”

Brink attended an event in summer 2019 with the inventors of the Lapiplasty technology, as well as podiatrists and surgeons from across the country, to analyze case studies, learn new techniques and brainstorm improvements for the already highly successful procedure. “There are always small modifications taking place to make it even better,” Brink said.

*Dr. Dale Brink is an independent medical practitioner and is not an employee or agent of Ingalls Memorial Hospital or University of Chicago Medical Center (“UChicago Medicine”).