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Old 10-24-2007, 10:25 AM   #1
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Bone fusion/foot/great toe

I barely know where to begin. My foot problems stem from arthritis in the large joint/big toe. I have undergone four surgeries in the space of two years: (1) reconstruction of the joint, (2) joint implant, (3) bone fusion with external fixater (I was on crutches/non weight bearing for six months), and (4) removal of the plates and screws a year after surgery. As far as I'm concerned the bone fusion surgery is a failure. I am in more pain now than I was to start with and would go back to the joint implant in a heart beat. The reason the joint implant failed was due to my development of fibrosis in the surgical area which resulted in pain because the joint was unable to move. These surgeries took place between 1999 and 2001. Throw in surgery for a ruptured disc/cervical and 3 months/24 hours a day in a hard collar, among other health issues, as well as the loss of both parents and a brother during that same time frame, and I suppose it's no wonder I'm suffering from depression. I have tried series of injections in an attempt to help with the nerve pain in my foot to no avail. I am currently taking Lyrica but can only take it at night because it makes me drowsy/dizzy. It is difficult to walk, my weight (what there is of it) is thrown to the outside of my foot which has resulted in a painful ankle, sore foot, painful spasms in my other toes, and the list goes on and on. Shoes?!? I would love to find a pair of shoes that aren't painful. I can't even wear sneakers. I am stuck wearing clogs which have recently started bothering me -- atrophy of the foot has progressed to the point where I can't keep an open shoe on my foot. I walk right out of it. And clogs are so chic -- try figuring out what to wear to a wedding, etc. when you can't wear shoes. I know that my problems are minimal compared to what some people go through in their life, but that thinking doesn't help me. It only makes me feel worse. I'm tired. I've been from doctor's office to doctor's office seeking help. And I suppose my question is, has anyone gone through what I have and is there any surgery that would improve my condition. Can I go back to a joint implant. I already know what the answer is. There is no help for me and I have to face the fact that I will live with this pain the rest of my life. Any suggestions to alleviate the pain?

 
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Old 10-24-2007, 12:41 PM   #2
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Re: Bone fusion/foot/great toe

Tweety, I am really sorry to hear about your story. I am a little bit behind where you are; next week I have my great toe joint fused together with a bone graft off my hips. If you search by my name, you should be able to find the thread I started.

I can understand your depression, I would imagine that everyone here can identify with it. I don't have any advice for that, it does help to talk about it, and I have enjoyed posting on this site and reading the responses I get. There was a time after I had my implant put in where I stopped going to doctors, just because it got to where I wasn't getting any new answers, just the same old stuff, and you get tired of hearing it after a while.

Are you currently under anyone's care? If not, I can suggest the ortho doc where I am going, he seems to be pretty good.

 
Old 10-24-2007, 01:06 PM   #3
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Re: Bone fusion/foot/great toe

hi tweetie, depression is a normal way of living after foot surgeries you had. its so sad that is has to be this way, but there are other options to try i think. i also had toe fusion after 2 failed surgeries. we use our feet to get around. i hope you are seeing an ortho now and trying pain management. i wish i knew what your dr told you. plus, i dont know how long it has been for you. there is no going back after fusion, but something else has to be done and maybe its a new fusion. i would seek several opinions. this board is a wonderful place to vent. maybe there are other people in your area that you can talk to. i cant stand not to be able to wear cute shoes, but i am walking. that i am walking without pain in sneakers is wonderful, but sometimes i would like to burn them. if you didnt have the pain, you would see things differently. i hope there is a dr outhere who is listening now. keep posting. debbie g

 
Old 10-25-2007, 08:12 PM   #4
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Re: Bone fusion/foot/great toe

I had bone fusion of my right great toe 7 weeks ago and I'm still in a lot of pain. The doctor says everything looks great and alignment is correct. Wondering if anyone else has pain this long after surgery. I have quite a bit of redness and some swelling yet under all the toes and it burns quite a bit. Is this my foot rejecting the pin. I see the doctor this coming Tuesday and he will do an x-ray and says I might be able to start walking. How can I with so much pain?

 
Old 11-05-2007, 09:26 PM   #5
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dbgoalie HB User
Re: Bone fusion/foot/great toe

Tweetie, are you still out there? Have you made any progress in the last two weeks? So far so good with me, I will be happy to recommend the place I am going if it would help you.
Lyndie, sorry to hear you are still in pain after 7 weeks. I am 1 week post-op; next week the stitches come out of my foot and I get a cast for a few weeks. Hopefully I am not in the kind of pain you are in after 7 weeks. We would like to hear from both of you, don't give up.

 
Old 11-10-2007, 05:42 PM   #6
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Re: Bone fusion/foot/great toe

Thanks for the reply dbgoalie. I went to the doctor back on October 30. He took an x-ray and said I am not quite healed all the way through, but that I could start walking if I don't roll my foot onto the toe. I asked him why I was swelling on the bottom of my foot at the base of the other toes. He didn't have an answer, said "I didn't do anything there."

He said everything looked great and couldn't explain why I had so much pain. I started walking with a walking boot and it actually made my foot feel better. I seem to be progressing each day now. I go back November 20th and hopefully the fusion will be healed. I think my pain is related to nerves healing. I get a lot of tingling and some burning when I am barefoot, less and less swelling. My foot actually feels pretty good in the walking boot. I put on a regular sock for the first time today. I do get a sensation like a rubber band being pulled tight around my big toe every so often, but not as often as before. Things are looking up! Can say at the moment I'm glad I went through this. Hope things go well for you.

Funny how different doctors do things. My doctor didn't take the stitches out until 3 1/2 weeks and I never had a cast.

 
Old 11-10-2007, 07:54 PM   #7
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dbgoalie HB User
Re: Bone fusion/foot/great toe

Lynide, give me a little history of what you had done please. This is operation number three for me. Broke joint of big toe when I was 15, had it cleaned out and a pin inserted for a few weeks to straighten when I was 30, at 34 I had an implant put in the joint since the cartilege had died, and at 37 (2 weeks ago) had the implant taken out and the joint fused. Hardware is holding the toe and foot together across the joint to allow it to fuse; the hardware will stay if there is no issue with it.

Do you have a pin in your foot or do you have a plate there? Funny you mention having pain on the bottom of your foot, I had the same problem after the implant was put in and it never really went away; I always had swelling and tenderness for years that never went anywhere. My doc said the same thing, he did no work there and couldn't explain. We tried therapy and I would see mild improvement, but it wouldn't last. If the therapist worked out the swelling, it would return. Personally, I think the swelling in the area was a reaction to the hardware, but no one would ever agree to that. My feeling was the implant would rub against the foot and the base of the toe as I walked, and that would generate the swelling in the area. The plate that I have currently in my foot is stationary, there won't be anything moving back and forth on it, so I am hopeful there won't be any swelling once I am recovered from surgery.

Nice description of the rubber band being pulled tight around your big toe. Now I am only 2 weeks post-op, and I also get that sensation every once in a while, like a sharp shooting pain through my toe that doesn't last long but it gets my attention. I wonder if that is a nerve shooting off or if it is something related to the bones fusing together? But that's a good description of the sensation.

 
Old 11-15-2007, 05:16 PM   #8
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Re: Bone fusion/foot/great toe

dbgoalie, I wonder about the hardware rejection issue, too. My history is not nearly as long as yours. My toe has been hurting off and on for about 2 years. The joint at the start of the year was pretty inflamed and swollen when I went in for my yearly checkup in March. My family MD said he thought I had gout, which I didn't really agree with and he didn't check any bloodwork to verify that guess. Anyway, it still hurt and on June 1. I went to a podiatrist to see what he thought. He took an xray and came in and said he had bad news, I had arthritis and in the top 10 worst cases he'd seen, mine was in the top five. He said I had no cartilage left. It was bone on bone and my toe was totally stiff, hallux rigidus. He suggested either a HemiCap or bone fusion. So I took a little time and got a second opinion from an orthopedist and he suggested with being active, swimming, walking, gardening, etc. that the bone fusion would be a better option for me and that I was already past the HemiCap. He said I would need a total joint replacement. I had discovered that my insurance wouldn't pay for the HemiCap (because it is considered experimental) and the ortho said the total joint probably wouldn't be covered either. So I opted for the bone fusion.

I blame my foot problem on going barefoot all the time. I know I have smashed my toe many times. But I told the ortho that when I step in water and then step on concrete, my footprint is only the front of my foot and the heel, there is no side of the foot in my footprint. He says that means my foot tips to the inside putting all the weight of foot on the big toe. That is probably the main cause. Anyway, I sure wasn't looking at having to have surgery, but I don't like putting off the inevitable and having the pain I had before surgery. Hopefully, this will help in the long run.

The procedure included cleaning up the joint. I had a few bone chips and a protrusion on the side of the joint. Then the joint was smoothed and I have a pin going diagonally, but no plate. The pin is supposed to stay in place unless there is a reaction. I thought I was getting a reaction, but doc says I'm fine.

The pain is getting better. Still have the same sensations but they are getting less strong. How you doing?

 
Old 11-15-2007, 08:36 PM   #9
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Re: Bone fusion/foot/great toe

Forgot to mention that there was a complication during the pin placement with the bone fusion. The guiding wire broke and they would have left it in there and used a different one but it popped up through the bone. In order to retrieve the bone, the ortho made in incision under the toe to pull the wire back out. I had a couple of stitches in the bottom of my big toe. Now I have a knot in that spot, probably just scar tissue.

 
Old 11-16-2007, 02:17 PM   #10
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Re: Bone fusion/foot/great toe

hi lyndie, sounds like you are doing well. i cant believe you only have a pin.

 
Old 11-16-2007, 05:26 PM   #11
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Re: Bone fusion/foot/great toe

The pin is pretty long and goes diagonally and I swear it is causing most of the pain I have. I haven't had a cast at all. I am getting around in a walker boot now and I actually feel better with the boot is on or at least having my foot wrapped. It's like the blood gets down to the foot and doesn't know how to go back up. If I'm barefoot, I need to massage it to get the blood circulating again, but if it's wrapped it seems to circulate better. I'm still not driving, but went back to work at 10 days after surgery on crutches. I work at a hospital and our office is the closest to an entrance (everyone helped me out so I didn't have to do any walking--just to the restroom and back). Sure is better now that I don't need crutches!

 
Old 11-17-2007, 12:26 PM   #12
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Re: Bone fusion/foot/great toe

when does the pin come out?

 
Old 11-17-2007, 01:45 PM   #13
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Re: Bone fusion/foot/great toe

Doc says it won't. Is that right? Do they usually come out?

 
Old 11-18-2007, 11:34 AM   #14
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Re: Bone fusion/foot/great toe

if you feel the pin is causing pain then something has to be done. i would go to another dr. i have not heard of a long pin like that, but i would check it out.

 
Old 11-18-2007, 06:10 PM   #15
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Re: Bone fusion/foot/great toe

Debbie,
Six months ago I had surgery on the MPJ where they cleaned out the joint, straightened the large toe and shaped the area where bunions usually exist, (I had no pain there but the doc felt it needed shaved). In addition to a screw in the large toe, a pin was put in, somewhat in the shape of a golf club or a wig pin in the shape of an L instead of a T. This pin was suppose to have been seated with the club edge towards the center of my foot. Evidently the pin popped out, rolled causing the club edge to push against the inside of the foot. (When I say club edge, the shape is not that of a golf club but normal pin size...it is just the short end of the pin) Since the area was delicate from the surgery and the pin was so close to the surface of the skin, it caused pain and discomfort when something pressed against it. In time the area toughened and pain was no longer evident....even in normal shoes.

 
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