Welcome to the Website of

Dr. Michael Zapf, DPM, MPH, FACFAS

 Thank you for visiting my website. I have been placing information and articles on this site for many years and have received millions of  hits during that time (and not that many of them were mine). I have designed it for people who like to read about their foot and ankle problems. Since I started the web site, I have added two associates to my practice, Dr. Darren Payne and Dr. Stephen Benson.  Since my site is filled with just my thoughts and opinions they are not, necessarily, shared by my colleagues. To see our less controversial (and less windy) practice web site, I offer you: www.ConejoFeet.com, the practice site for The Agoura Los Robles Podiatry Centers (ALRPC). The ALRPC practice site has a lot of material about our office, many of our policies and the registration forms to be filled out before your visit. I suggest all prospective patients visit www.ConejoFeet.com.

 I made the web site to give my patients the extra depth information that I don’t always have time to cover in the office visit. Visitors who are not my patients are welcome to browse the information found here. My younger colleagues are both under 50 and they, like many their age, do not favor in depth reading. They prefer their information presented to them in a few short, crisp bullet points. I, being of the, ahem, older generation, like to read about my ailments in greater depth. Here, I present the greater depth. If you ask a question about heel pain or bunions that I have not answered in my two monographs, I will quickly add it so that it is as complete as I can make it. If you agree with this philosophy, welcome to my page. If you correspond with me please let me know if you like the in depth reporting.

 Remember, this site is in no way intended to tell you how your own ailment or problem should be treated, only the approach I use when confronted with certain situations. Your problem may well be different from what you think it is and should always be evaluated by the appropriate professional, whether podiatrist, orthopedist or other authority. Please understand that I, nor anyone else, can offer you a proper diagnosis or treatment plan without seeing and feeling the problem at hand (foot?).  Happy reading.

 Sincerely, Michael Zapf, DPM, MPH, FACFAS, FACFAOM

 P.S. All the information in this web site is © by me and it is mine alone. No picture or any of the articles cannot be used by anyone without permission from me, personally.

01/08/2012

To Order Foot Supplies --> <-- click

Bunions – Wasted on the Youth                                    Acorn June 2008

By: Michael Zapf, DPM, FACFAS

     We did an elegant procedure on Devon this morning. Devon is a 14 year old high school freshman who had bunions. Yes, I know, bunions are usually found in adults. But kids get them too. Devon, in fact, had recognizable bunions as early as 9 years of age. Her pediatrician told her to wait until she was an adult to do anything about them so she and her parents tried to ignore them. That lasted for three years until her bunions began to hurt so much in soccer shoes that Devon could no longer ignore them. Devon’s mom heard about a procedure that we do in our office for these so-called juvenile bunions and, with the blessing of her pediatrician, came to our office for an appointment.

     I had the pleasure of seeing Devon just before school recessed for the summer. I agreed that she had adult sized bunions and I also agreed that for most bunion procedures we should normally wait until her bones were fully mature. But in our office Devon had one more choice: growth plate stapling. I explained the procedure to Devon and her mom that day (an explanation with photographs can be found on our web site www.conejofeet.com), to her pediatrician a week later and we did the procedure on both feet earlier this morning.

   In a bunion, one of the long bones of the foot, the first metatarsal, moves away from the other four. It can move so far that you can see the front head of the metatarsal bulge out the side of the foot behind the big toe. Devon had a large bulge or bunion. In an adult we simply make a surgical fracture in the neck of the metatarsal and move the bulge back toward the foot. For a variety of reasons we usually do not do this in children.

   Metatarsals, like all long bones, have a growth plate at one end where the body grows new bone cells so the bone can get longer. The growth plate for the first metatarsal is at the opposite end from the head back by the base of the bone. We have found that if you place a half inch wire staple across one side of this growth plate you can slow the growth of that side of the metatarsal. For a bunion slowing the inside of the bone growth causes the first metatarsal to move back into the correct position. We try to gauge the time for the surgery so that we can get just the right amount of correction without any overcorrection. If we get complete correction and there is growth remaining we can simply pull out the staple to stop the correction before it overcorrects. In most cases we can just leave the staple in the foot and it causes no harm.

   Devon is resting at home tonight and may be taking a pain pill or two but the pain is rarely anything more than mild. In two weeks she will be in tennis shoes and two weeks after that she may well be back on the soccer field. It always amazes me how well these young adults do after surgery. This is such a great procedure that it has become a, ahem, staple of our practice.

Dr. Michael Zapf is a partner in the Agoura-Los Robles Podiatry Centers with offices in Agoura Hills and Thousand Oaks. For more information call (818) 707-3668 or visit the web site www.copnejofeet.com. 

Send mail to (zfootdoc at doctor dot com) with questions or comments about this web site.
Copyright © 2000 Michael A. Zapf, D.P.M., F.A.C.F.A.S., F.A.C.F.AOA.M.
Last modified: January 08, 2012