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Old 06-05-2007, 06:56 PM   #1
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Big Toe Fusion

I am being referred for a fusion of my big toe joint. The joint is full of arthritis to the point that the joint is totally destroyed with no other options available. I have had arthritis in this joint for over 30 years and this is just the end result. It is very important for me to have this joint fixed as I am only able to walk on the side of my foot right now and I can no longer wear any shoes other than loose fitting crocs. I also have problems with my other leg due to nerve problems in my back and I depend on this crippled foot to take on my weight when I walk.

My question is how long is it before I will be able to put any weight on this foot. Remember for me this is important because I don't have another strong leg to stand on with crutches. This is the only good leg I have.

Beginning to wonder if I will need to have a scooter after surgery and how long the recovery usually is. Figure the surgeon will answer my questions as best they can but just wanted to know anyone elses experience. I walk with a walker or a cane when able so running or walking any distance is not in the cards for me now or after surgery.
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Old 06-05-2007, 07:20 PM   #2
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Re: Big Toe Fusion

There are quite a few of us on this forum that has had their big toe fused.
I had my big toe fused with graft plate and screws after a failed Keller surgery. My fusion was exactly 1 year ago. I have rheumatoid arthritis so many joints are affected and crutches were a problem. I was non weightbearing for 12 weeks (typical is eight weeks but I had a graft used so 12 weeks was the reason). I still slightly gimp now but at the end of the day I may gimp a little more because I still swell when on my feet a lot. I also had surgery 2nd and 3rd toes as well then. I'm glad I had the surgery because the pain I had before is absent. I will probably need my other foot done but will wait till at least later this year. Best of luck.
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Old 06-06-2007, 05:57 AM   #3
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Re: Big Toe Fusion

Hi Janie,

Can you explain what a "failed" Keller Procedure is? what happend as a result that you needed a fusion? I was scheduled to have this done tomorrow and canceled because I am getting around fairly well at this time. I have lost a lot of cartilege in my large toe and have some bone spurs as well. I am sure this feeling better thing is temporary at best. I am just so fearful of having surgery and making things worse. My POD did explain that I will be fitted for orthotics again after the surgery and that my large toe might be elevated but that it would also be shorter and floppy. My concerns now were his mention of infection, nerve damage, etc. All the potential side effects one cou;ld think of! I know he has to list them all but I really started to give this more consideration the closer I got to the surgery date. I am 65 and this has been slowly progressing for the past 5 years.

Will delaying this procedure lead to a fusion later on? Never thought to ask the Dr. that question. Also, I did get several opinions and the Keller was recommend by 3 Drs over the course of the last year as the best procedure for me. Maybe the age thing?

Thanks
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Old 06-06-2007, 02:37 PM   #4
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Re: Big Toe Fusion

8 weeks is typical after toe fusion and non weightbearing. a wheel chair sounds good and so does the scooter. just make sure somebody is there to help you. ask your dr what else you can do

 
Old 06-07-2007, 05:35 AM   #5
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Re: Big Toe Fusion

Hi Stitcher317. My Keller on the big toe made it too short and floppy and my
balance was not there...it almost felt like I had no toe and the pain kept getting worse and worse. The doctor said that what he did with the surgery
didn't work for me. I did a lot of research AFTERWARDS and found that the
Keller is very rarely used and for people who are not active. I am in my mid 40's. Even if one was elderly I would think they would want some stability with their walking so, I myself would never had the Keller procedure (if I had known what I researched) I'm happy with the fusion at this point. The toe does sit up some but it is not floppy and there is more stability. I also had toes 2 and 3 done at the same time with osteotomies. My suggestion is to do a lot of research and learn the pros and cons of the procedures and how they would affect your lifestyle. Fusions in general are the longest for the recovery but they are permanent. If there are no complications (sometimes fusions don't heal fast enough) then you have a permanent solution.
Janie

 
Old 06-07-2007, 07:57 AM   #6
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Re: Big Toe Fusion

Hi Janie, Thanks for your input. I have consulted with many PODS both here and in Fla. and had recommendations for the Keller by 3. One recommended an implant, and OS recommended just snipping the bone spurs for now knowing that something more radical would be needed in the future, maybe 5-7 years down the road. I don't want to address this again! Another OS recommended I wear special leather boots and forget surgery until I can't walk anymore...UGH

I do know that the Keller is not recommended for active people and at 65 I am VERY active. I love to walk for exercise, etc...My POD says this procedure has worked well for him. He combines the procedure with special orthotics used to support the floppy toe issue. I guess in the long run there are several options available and the one you ultimately choose is probaby one your surgeon has positive results with.....I know the fusion is the last resort if all else fails. Logistically, being off my feet for such a long period would be very difficult.

Very confused at this point......
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Old 06-08-2007, 04:12 AM   #7
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Re: Big Toe Fusion

Why not have the procedure YOU want from the surgeon who does it best....rather than the procedure your doc does best because he says so?
Something a little out of kilter to me about that statement, Stitcher. Seriously. You say you want to get this over with and not have to deal with it again. Well, the orthotics is dealing with it every day...every time you change shoes, every time your foot changes a little. I think 5-7 years from the cheilectomy is a great outcome. Not to sound fatalistic but you might not even be around in 7 years. Or, you might get more than that out of the surgery....I'll admit I just had such a great outcome I can't imagine doing it any other way. Just some stuff to think about.

 
Old 06-08-2007, 06:28 AM   #8
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Re: Big Toe Fusion

Titchou -
I totally agree with you and I think this is why I am hesitating at this time. Who knows where I'll be in 5-7 years or better yet, what I'll be doing.

What I have learned about the Keller is that it addresses the loss of cartilege and arthritis in the joint. When you see my xrays, there is almost no joint space left at all. I was told that the cheilectomy will remove the spurs but as the big toe joint moves it's rubbing bone on bone....thus the suggestions for either the Keller or a hemi implant.

I was also leaning toward the Keller as I have 2 friends that have had it (total of 3 feet) and have absolutely no problems. One is 17 years out from her procedure....My hubby had a cheilectomy about 15 years ago and his joint "auto fused". New term for me...in any event, his toe joint totally fused on it's own. He is pain free but now has a huge mass in the ball of his foot. He walks the golf course 5 times a week and continues to play agressive tennis 3-4 times weekly. His gait has change somewhat in the past few years, however. Anyone know anything about joints fusing on their own? Saved him going through the recovery of a surgical fusion.....lucky guy?

It is certainly interesting that you can go to 5 different Drs. and get 5 different opinions. I truly appreciate all this input.....In the past few days I notice when walking barefoot, I am walking on the outside of my foot and cupping it somewhat.....UGH! I think I am going to have to make a decision soon....
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Old 06-08-2007, 07:11 PM   #9
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Re: Big Toe Fusion

My toe almost totally fused but it has fused crooked. It is over to the side underneath the second toe. After reading all of your responses I am thinking that perhaps I might ask the surgeon about a joint replacement. I am 63 years old and disabled. My walking is limited so that my foot on the best of days is never going to be getting a big work out. I know the downside of a joint replacement is that it will wear out eventually but I am older and inactive so I suspect the wear and tear will be slight. Joint replacement may offer me a greater selection of shoes to be able to wear. At present I can only walk with the aid of a cane or walker and my arthritic foot is on my good side. There will be no crutches for me during recovery making things a little more difficult.
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Old 06-08-2007, 07:48 PM   #10
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Re: Big Toe Fusion

Hi Pooby,

You say your toe is partially "fused". Does this eliminate the pain since the joint isn't moving anymore?

My huuby's joint "auto fused" but he doesn't have any pain at all....the toe doesn't move eitherl.

Even if mine fused on it's own, I believe the bone spurs are what is causing much of my discomfort. I am angry and disappointed with myself for canceling the surgery and thinking that this won't get any worse. I can reschedule at any time and will reconsider after I finish a full week of NSAID's to see if anything improves.
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Old 06-09-2007, 10:05 AM   #11
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Re: Big Toe Fusion

I have horrendous pain in my toe. By Horrendous I mean sometimes if the sheet is pulled too tight over the top of it pain shoots up to my ankle so obviously something isn't too good. I get pain just sitting with it up on a pillow with no weight on it. It swells up. The swelling runs from my big toe joint over my second toe joint. As I said the toe can still flex very slightly. At present I hobble on the side of my foot. It is fusing in an the wrong position according to my doc. Who knows what nerves it may be pressing on.
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