Can anyone give me any information about first tmt joint fusion?? I had bunion surgery (osteotomy) 15 years ago and the mtp joint is not too bad....but the first tarsometatarsal joint is the problem. What can I expect with regard to surgery and recuperation? (Non weightbearing, casting etc.) :confused: I am very worried about what to expect...please let me know the good and the bad. Thanks in advance!

Hi,
I had my FMT joint fused about 10 months ago. I can say life is different but it is OK. I am not in constant pain anymore and I have learned to deal with a stiff toe, its really not so bad aferall! I wasnt in a cast because I had bad tissue breakdown, uncommon I might add so I was wrapped and in a splint and my hubby had to change my dressing 2x a day. I was NWB for 5 weeks.........I had a walker to use as crutches and me didnt get along! I went into a surgical shoe for about 3 or 3 weeks after that then into a sneaker. I am now wearing sandles, flip flpos and a half inch heal should I chhose too. I also have 2 screws which I am going to have taken out soon as they bother me. If you read through any of the fusion post you will see that all DR's dealw this differently...........sone are NWB longer, some can walk on the heel.........they all seem to have thier own method. I will tell you the recovery was awful...........it was my 5th foot surgery on the same foot so I had a hard time BUT it is worth it!!!!! I have NO REGRETS AT ALL!!!!!!! I will answer any questions you may have, I am not on all the time anymore but will subcribe to see if you post. Good luck to you............have you sheduled this yet?
Dlh

:wave: I'm 11 weeks post op today. Like Dlh, I was NWB for 5 weeks. I thought it would be for 8, I also had no cast, which I thought I would. I wore a wierd sloping boot from week 5 - 8 and then whatever shoes tolerable. I also had a bone graft from my hip into my foot, so I was hospitalized over night. I needed 1 - 3 Vicodin a day for the first several weeks but only an anti-inflamant every couple of days now. The hip has been really sore but now feels more like it's just bruised. I walked in sand pain free for the first time in a few years the other day and can wear some of my old shoes. I still can't do much but more each week. Do what the Dr. says, take it REAL EASY and don't rush anything. When it hurts, I stop. Sometimes I still use the electric cart for shopping and I usually don't go to stores that don't have them. Get some books and DVD's and give yourself this break, it will be better in time. These boards helped me a lot and I hope this helps you. By the way, I had a bunionectomy in 1/03 for cartilage damage, not a bunion, and then a joint implant in 9/03 that didn't "seat properly" so haven't been pain free for a long time. It's actually better now than since before the first surgery, thank God.

Thank you so much for your replies. Just so I can get it straight, it is not the mtp (toe) joint where the bunion was but the first tarsometatarsal joint (which seems sort of on top of the arch). I have been having such pain especially since April and have been in and out of the boot. It seems there are bone spurs and/or arthritis there. From what...I don't know! Is that the same place you had the fusion? I don't see how this makes the big toe stiff if it's not the big toe joint (ie not the mtp joint)?? Really mixed up right now...all I know is something has to be done. This is my third doctor (a board certified podiatrist) and I really like him. If I call the office he always returns my calls. The other (an OS) told me there were no more problems with my foot. Thanks again. Why did you have the fusion?? Sorry for so many questions!

Thank you so much for your replies. Just so I can get it straight, it is not the mtp (toe) joint where the bunion was but the first tarsometatarsal joint (which seems sort of on top of the arch). I have been having such pain especially since April and have been in and out of the boot. It seems there are bone spurs and/or arthritis there. From what...I don't know! Is that the same place you had the fusion? I don't see how this makes the big toe stiff if it's not the big toe joint (ie not the mtp joint)?? Really mixed up right now...all I know is something has to be done. This is my third doctor (a board certified podiatrist) and I really like him. If I call the office he always returns my calls. The other (an OS) told me there were no more problems with my foot. Thanks again. Why did you have the fusion?? Sorry for so many questions!


I have had that joint and a few others fused in the mid foot. The cast was on 13 week and then the boot for 2 weeks all absolutely no weight bearing. I was then about 9 weeks walking in the boot. the foot does look good

Janet

Thank you so much, Sew4you2. If you don't mind could you elaborate a little more. In patient or out patient, Pain level and time frame before surgery. Was it for arthritis or possibly something else? I'm asking because I don't know how many things to try first! Any problems with walking now? Shoe restrictions? Thank you so much in advance for your help!!

There was some arthritis. It was the result of a navicular bone fracture that was "missed" several years ago. I have some shoe restriction due to a fusion in the great toe. The surgery was out patient. I had to go the San Francisco about 100 mile from home to find a surgeon with the necessary skill. Do shop for the doctor. The one who did my foot is an instructor at UCSF medical school. I do not remember that the pain was too much. I just remember that I read more than I ever wanted to.

dlh...thank you for checking in. Nothing has been scheduled yet. I was hoping to see if anyone tried anything else to rectify the pain before surgery. Maybe immobilization for a period or something else. I keep thinking if weight is taken off it for awhile it might feel better. I will need to talk to the doctor about this but don't have another appt. for 2 weeks. Just really wanting to start walking exercise program again.

That is why I had the surgery. I was always in pain. Walking was almost imposible. Now there are still times of pain, but not as much.

dlh...thank you for checking in. Nothing has been scheduled yet. I was hoping to see if anyone tried anything else to rectify the pain before surgery. Maybe immobilization for a period or something else. I keep thinking if weight is taken off it for awhile it might feel better. I will need to talk to the doctor about this but don't have another appt. for 2 weeks. Just really wanting to start walking exercise program again.



I had the surgery because I was always in pain as well..............tried everything to avoid it but nothing would relieve it for any amount of time. I even tried staying off of ot, insoles, meds............the fusion was my onlt option. I am sorry if I confused you.......I did have my big toe joint fused.........I may have written it wrong, all these abb. can mess me up.......must have missed that class in med school.....ha ha :D
Anyway it is my big toe joint which is why it is stiff & the shoe limitations, etc...if you are comfortable with your DR that is half the battle and if he listens to you and answers all your questions great! That is a good thing and you have to be sure before moving ahead, if any doubts at all wait! I have no regrets at all, it is amazing to get up and have that pain be gone! Keep us posted! I am rooting for you!
Dlh

Hey there
Well Here is my story, and I will say I have been through the ringer, My name is Karrie and I live in Washington State, I just had my fifth mind you operation on my big toe two weeks ago, I have degeneative artharetic issues in the big toe, and the first set of operations just a cleaning out of the area, pins etc, then the pins became dislodged in the toe and out they came and at that time I chose to have the titanium implants in, well they a year and half later, Here I am again only this time the implnts failed so the only option is fusion of the big toe with a metal plate, and also they had to graft the joint of the big toe and luckily were able to graft the area from the toe not the ankle which would of caused just another area of pain, they also graft with it being taken out of the ankle, anyway Yes it hurts and I am in a boot air cast for two months, which then again causes other issues back aches really bad and I can not take ibiprofen it makes me sick so pain killers it is, which after on them for a long time for rotator cuff operation twice in one year, they do not work as well, so that sizes it all up in a short little deal here. I wish you luck with the fusion, I am hoping once for me when all the bandages come off etc, that I will hopfully be on the road to a smooth recovery, although I have to go in and have the plate taken out they put in there, and then as soon as I am ok to walk on this right footy, they will go in and take the other implant out of the left, and we will have to do it all over again, joy joy. So for the most part people do great I have heard once you heal, for me on the other hand its been a complicated last four years of nothing but surgeries, I am an old pro at this by now, and have everything in my house from crutches to left over scrap metal lol called titanium which by the way you can never reuse for anything, which is kinda funny, once its inside of you, it can never be used again for anyone else even with sterilization, which is odd, and its worth 1 to 2 thousand dollars the doc says, so they will be used as a really nice looking funny pair of cufflinks lol for my hubby, as we laugh at the thought, so anyway that is my story, and Keep in touch, and I will do the same, this boot and I are buddies for a long time, and its annoying, and painful still, but I and you if you have this done will get through it.
Blessings
Karrie

Well surgery is finally set for the 18th.Pre-op appt. is Monday. Maybe 2nd met shortening and clean out tmt joint of arthritis or 2nd met shortening and fuse tmt joint. Not sure!! A little scared. I thought it would be IV sedation but it will be general anesthetic... Not sure of all the questions to ask the doctor....just glad that the pain may end soon! Thanks to everybody for their support!

Friday is fast approaching and I am scared. If anyone can post some encouragement I would really appreciate it!! Dlh...SoCal Sharon.... Sew4You2...JDMidwest (Jill)...Anyone else Thank You...Why am I so worried...I had too much time to prepare! Any words of encouragement would help...

:wave: Hey Sophie,
Of course you're nervous, there's a lot at stake and you've been through so much already. The good news is, your waiting is nearly over. I used to think the waiting was the worst part, and I do hate it, but I think it's more the not knowing if it'll all turn out ok. So come this time next week, you'll be post op and happily recuperating, watching those favorite movies, getting caught up on your reading and hopefully getting a little spoiled by the ones who love you, then before you know it, walking again. :bouncing: Keep yourself really busy these next couple of days and listen to soft music, enjoy the scenery, take slow, deep breaths and know somehow, it's going to be ok. Pray. Meditate. Relax. :angel: I visualized God holding me in His arms which brought me comfort. Please, keep up posted as to how it's going and finally, remember you'll be in our prayers too!
Sharon :cool:

Sophie: This is the hardest part!!!. Just think how much better you will feel when it is over. Sending good thoughts for a great outcome and a speedy recovery. Will put you on our prayer chain. Julie

Sharon and Julie thank you both SO MUCH!! Everyone here has been so wonderful and it truly helps so much to be able to talk to others who have been through it and understand. I'll let you know how everything goes. Thanks again!

:wave: Hello again, Sophie,
It occurred to me that you might have to change your sign on to Notsorefootsophie ;) , let's hope. I noticed on another thread you asked about where the bone comes from for a fusion. Some fusions are done without a bone graft and with plates and screws, although I don't know exactly how they do it. In my case, I had bone taken from the iliac crest of my hip. Hip bone is considered the "gold standard" for success in bonding with the existing bone. There is also synthetic grafting material, and cadaver bone. Your own bone is usually preferable but it does create yet another surgical site and :eek: more pain. I'm at about 4 months post op now and whenever I stand up it feels like my hip is kinda stuck and it often aches. Oh, well. Mostly I'm better all the way around. I know my fusion was a different joint than yours, I think mine's called MTB so I don't know how that changes things, I do know they often use the hip for spinal and other fusions so that part probably applies. Let me know what they do in your case. Anyway, I know you're almost there and I'm cheering for you :jester: .
Sharon :cool:

Sharon, Thank you so much. It's the middle of the night and I can't sleep (part nerves...part sore foot). I don't even know at this point if there will be a fusion done (definitely 2nd met shortening). My wonderful doctor says only if absolutely necessary. I do know he mentioned a plate and screws. I said do whatever so I don't have to come back in a few months...From what he's said the PT is more difficult with a fusion but the recovery time will be about the same either way. I think the nwb is the scary part especially since I've never had that before and I'm "older" now!! I'm just not used to sitting still. Anyway, thanks again. Sophie :yawn: