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Dr. Fernando Fernandez, a podiatrist, holds a model of a foot with the two low-profile, anatomically-shaped titanium plates used in the Lapiplasty 3D bunion correction shown Friday, March 4, 2022, in The Woodlands.
Dr. Fernando Fernandez, a podiatrist, holds a model of a foot with the two low-profile, anatomically-shaped titanium plates used in the Lapiplasty 3D bunion correction shown Friday, March 4, 2022, in The Woodlands.
Dr. Fernando Fernandez, a podiatrist, is shown with before and after x-rays of patient’s feet Friday, March 4, 2022, in The Woodlands. The Lapiplasty 3D bunion correction uses two low-profile, anatomically-shaped titanium plates.
Dr. Fernando Fernandez, a podiatrist, holds a model of a foot with the two low-profile, anatomically-shaped titanium plates used in the Lapiplasty 3D bunion correction shown Friday, March 4, 2022, in The Woodlands.
An after x-ray of a patient’s right foot is shown in the office of Dr. Fernando Fernandez, a podiatrist, who uses the Lapiplasty 3D bunion correction on Friday, March 4, 2022, in The Woodlands.
A before x-ray of a patient’s feet is shown in the office of Dr. Fernando Fernandez, a podiatrist, who uses the Lapiplasty 3D bunion correction on Friday, March 4, 2022, in The Woodlands.
An after x-ray of a patient’s left foot is shown in the office of Dr. Fernando Fernandez, a podiatrist, who uses the Lapiplasty 3D bunion correction on Friday, March 4, 2022, in The Woodlands.
A model of a foot with the two low-profile, anatomically-shaped titanium plates that is used in the Lapiplasty 3D bunion correction is shown in the office of podiatrist Dr. Fernando Fernandez Friday, March 4, 2022, in The Woodlands.
Before and after x-rays of a patient’s feet are shown in the office of podiatrist Dr. Fernando Fernandez, Friday, March 4, 2022, in The Woodlands. The Lapiplasty 3D bunion correction uses two low-profile, anatomically-shaped titanium plates.
Dr. Fernando Fernandez, a podiatrist, is shown with before and after x-rays of patient’s feet Friday, March 4, 2022, in The Woodlands. The Lapiplasty 3D bunion correction uses two low-profile, anatomically-shaped titanium plates.
Dr. Fernando Fernandez, a podiatrist, holds a model of a foot with the two low-profile, anatomically-shaped titanium plates used in the Lapiplasty 3D bunion correction shown Friday, March 4, 2022, in The Woodlands.
Miriam Romero began having bunions — an inflammation that forms on the toe joint — when she was a teenager.
“I feel like I’ve had them my entire life,” the 45-year-old Hockley resident said.
And no matter what type of shoes Romero wore or how she tried to make them disappear, the bunions remained and grew painful.
“I got used to it, to tell you the truth,” she said. “I just thought that this was going to be the way it was.”
Surgery did not appeal to Romero. She had heard of others who signed up for bunion scraping procedures, which would remove bone from her foot. The operation sounded too painful — and had too long a recovery time — to seem worth pursuing.
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Still, the bunions kept growing. She was no longer able to wear the shoes that she wanted and had to find certain sizes to accommodate the bumps on her feet.
That led her to do some internet research — and she found the website of Dr. Fernando Fernandez, a podiatrist in The Woodlands.
He specializes in bunion correction at the practice Advanced Foot Care and offered a service Romero had never heard of before: Lapiplasty. The procedure treats the root joint issues causing the bunions and offers a quicker recovery time.
“People don’t know about it,” she said of Lapiplasty. “You don’t have to suffer through bunions. People think that they have to go through the pain, that it’s normal. No. There’s another option.”
Fernandez said a common misconception about bunions is that they are simply bumps that need to be shaved off, a procedure called exostectomy.
“A lot of people think a bunion is just an outer growth of the bone,” he said. “But it’s much more than that.”
The true problem is an unstable joint in the middle of the foot. “Follow your toe and travel toward the middle of your foot,” Fernandez said. “That’s where the problem is occurring.”
When the joint is unstable, the bone drifts out of alignment. Bunions result, a symptom of the root cause.
Bunions usually occur with people who have a family history and are predisposed, Fernandez said. Having a flatter foot can also lead to the formation of the growths.
“Certain shoes and activities tend to cause more discomfort,” Fernandez said. “But the shoes don’t cause it. They can make the condition appear a little sooner than it normally would.”
When a bunion is shaved down, the procedure does not address the true issue, the podiatrist said, which is why the problem often recurs.
“Cosmetically it looks good, but the bone is still out of alignment,” he said.
In the past, Fernandez had tried another surgery to realign the joint, but recovery was lengthy. Patients were unable to place weight on their feet for about six to eight weeks, before wearing a protective boot.
“It required so much time being off your feet,” Fernandez said. “The patient was pretty miserable.”
That’s why Romero passed on the surgical option.
“I’m never going through that pain,” she said she thought before finding Fernandez. “And I didn’t have the time to lay in bed all day. If they would end up coming back anyway, why even bother?”
About four years ago, Fernandez discovered the trademarked Lapiplasty procedure, which promised a quicker recovery. The procedure was developed in 2014 by Florida-based Treace Medical Concepts Inc., an orthopedic medical device company.
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The patented procedure is “a combination of instruments, implants and surgical methods designed to correct all three planes of the bunion deformity and secure the unstable joint, addressing the root cause of the bunion and helping patients get back to their active lifestyles,” the company’s website explains.
It didn’t take long for Fernandez to add Lapiplasty to his arsenal.
“This option was intriguing,” he said. “It looked like the right thing to do for a patient.”
On average, patients who undergo the procedure only wait three to eight days before bearing weight on their feet and then move into a protective boot for six weeks. After that, he recommends wearing sneakers for another two months.
“Then you transition back to comfortable shoes,” Fernandez said.
The surgery is complex and requires adjusting the joint, then adding screws to hold it in place. Multiple incisions are involved.
“We’re essentially fusing the joint,” Fernandez said. “Then it’s stable.”
The bunions recur in 1 percent to 3 percent of patients, compared to a 70 percent return rate with exostectomy or shaving.
“Before, there was always a second thought that it was going to come back,” Fernandez said. “Now, you don’t have to worry too much about it.”
Fernandez has performed the Lapiplasty procedure about 250 times over the past four years.
Romero had her right foot done in September 2020.
After about a four-hour operation, Romero rested for the weekend, relying on a walker or crutches to keep pressure off her foot. “By Monday, I was back walking by myself,” she said. “It was amazing.”
Romero wore the recovery boot for about two months, then sneakers for three more months.
“Once I saw how manageable everything was, I wanted to do my other foot right away,” she said.
Romero scheduled the procedure on her left foot in March 2021 and followed the same course of recovery.
A year has passed since her second operation and her feet remain bunion free.
“I’m back to normal,” Romero said. “I can run. I can jump. I can do whatever I want.”
And that includes sporting the cute shoes bunions kept her from wearing.
“My feet don’t bother me anymore at all.”
Peyton is a freelance writer in Houston.
Lindsay Peyton is ReNew Houston's Transformation columnist.
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