In the news

July 7, 2022

A new approach to this common conditions faster, easier and less painful

Audio engineer Doug Nightwine is often on his feet for 16 or 17 hours a day, providing sound for concerts, television and corporate events. So when he developed a bunion — a bony bump on the joint at the base of his big toe that can eventually deform the foot — he couldn’t ignore the swelling and soreness.

“It was becoming more and more uncomfortable,” he said. “I couldn’t wear dress shoes without pain.” Even so, he kept putting off treatment. Bunion surgery has long been known as a painful procedure, one that can cause swelling and stiffness lasting for months. “My friends had scared me with stories about their long, difficult recoveries,” Nightwine said. “Then I met Dr. Spielfogel.”

Nightwine is referring to Lenox Hill Hospital’s chief of podiatry, William Spielfogel, DPM. The hospital offers a new, less invasive approach to bunion treatment, said Dr. Spielfogel, and it was worth Nightwine’s serious consideration.

In a traditional bunion procedure, the surgeon makes a large incision over the top of the foot, cutting through and repositioning the first metatarsal bone — the long bone in the foot that connects to the big toe — and then fixing it in place with screws. It’s an involved procedure that can require significant downtime, decrease mobility and leave scars.

The new approach, called Pecaplasty, avoids the big toe joint, making tiny incisions on the side of the foot. “This means less disruption to soft tissue, resulting in reduced swelling, greater range of motion in the joint and a quicker, less painful recovery,” Dr. Spielfogel said. “There’s also less visible scarring.”

Lenox Hill Hospital was one of the first hospitals in the country to offer this minimally invasive procedure and is one of only three New York City hospitals currently performing it. “We have seen very good results,” said Dr. Spielfogel. “Most patients are back in their sneakers within four weeks.”

Nightwine’s surgery went smoothly, as did his recovery, and soon he was able to wear sneakers without discomfort. Today, he’s back in dress shoes, wearing them even for long work events. He’s glad he tackled his bunion, he said. The surgery was a surprisingly easy way to get back on his feet.