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Old 10-30-2003, 11:40 AM   #1
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Unhappy Callus Distraction....Callotasis

After spending hours reading about bunion surgeries gone haywire, I finally got registered so that I could post. I've been a lurker for several weeks.

I had surgery on Tuesday to begin the process of lengthening my big toe that was shortened during my second bunion surgery. The process is known as callotasis. Has anyone out there had any experience with this?

My saga began with surgery last November. I had a bunionectomy on my right foot along with a bone spur and hammer toe. I also had a hammer toe repair on my left foot. I left the surgery center that day walking on two heavily wrapped feet. My doctor's instructions were to take it easy and only walk with the reshoes on my feet.

With my doctor's approval I returned to work after a week of staying on the sofa with my foot elevated. I'm an assistant principal in an elementary school and spent quite a bit of time in my office with my foot propped up. I'm a type A personality and going back to work was my choice since I really don't like just sitting around doing nothing.

According to my doctor everything was fine. I got to ditch the reshoe on my left foot 3 weeks after the surgery. I continued to have lots of swelling in my right foot. Finally, seven weeks after the original surgery, my doctor called me to come back to his office. He had spent some time studying my last x-rays and confronted me with the news that the screw had not stayed in place. He said I had to have walked without the reshoe and that I had caused the problem. The only thing to do was to redo the surgery.

I was scheduled to have surgery at 9:15. I finally was taken for the surgery at 2:15. Two of the patients had had complications. I even asked the doctor if he wanted to put the surgery off until another day cause I knew the whole team had to be tired.

After the surgery the doctor told my husband that he had had to cut away part of the bone on both sides of the break so that he could put a new screw in place. This time he put me in a splint with crutches. He changed the splint to a hard non-walking cast which I was in for five weeks. When he x-rayed my foot after removing the cast, he found that there had been no growth because the two pieces of bone were not touching each other. He did not get good compression.

He ordered a bone growth stimulator ($4,470) and put me in an air cast. I used the bone growth stimulator for 10 hours per day for over three months. When the bone finally grew back together I had yet another problem. For some unknown reason the screw needed to be removed. I had that surgery in July.

When school resumed in August, I started experiencing a great deal of pain on the ball of my foot under the second toe. Immediately my doctor diagnosed it as a neuroma and wanted to schedule more surgery. I went for a second opinion.

The second doctor was not at all convinced that I had a neuroma. He had me put orthotics in my shoes and gave me a shot of cortisone. The next week he put me back in the aircast to give my foot time to rest. After three cortisone shots and three weeks in the aircast, he sent me to yet another doctor with the news that the shortened big toe was causing my weight to be carried by the second toe. Both this doctor and the one he sent me to suggested that I have surgery to lengthen the bone.

After much thought, I decided to have the surgery. I am 60 and want to remain active. I had gotten to the point that all shoes hurt. It just hurt to walk in anything other than the aircast.

I had the surgery on Tuesday. After about 10 days I will give the pins on the external fixation device a turn two times each day which will cause new cartilage to form and then be turned into bone. I need a centimeter's growth. I am taking the pain medication and keeping my foot elevated. I'm anxious to get back to work.

Has anyone every heard of this process? I would love to hear any information that anyone has. I'm going to keep this thread alive while I go through this process. It may help someone else someday.

Judy

Last edited by mom2chet; 04-10-2004 at 06:39 PM.

 
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Old 10-30-2003, 06:40 PM   #2
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Hi mom2chet,
I can relate to the problems you are having to some degree and since you have been reading about the bunion surgeries gone haywire, then you have probably read my saga as well. I have heard of metatarsal lengthening but I didn't know what the name of the procedure was. A centimeter too short sounds like quite a bit. My 1st metatarsal was shortened enough to cause a lot of pain under my 2nd metatarsal head but not enough to do a lengthening procedure on.

In my case, my new surgeon will shorten the 2nd metatarsal by about 4 millimeters (I believe that is how much she said) but she will use x-rays in the OR during the shortening process to get the best correction possible without over-shortening the 2nd metatarsal which would result in the same problem with pain under the 3rd metatarsal head. It sounds kind of tricky and I am kind of scared about it but the pain under my 2nd metatarsal head is now so intense that I am going to try it. She will also smooth down the 2nd metatarsal head condyle on the bottom of my foot.

Were your hammertoes repaired correctly? Mine on that same 2nd toe was not which adds additional downward pressure to the metatarsal head so my surgeon will also do a bone graft (using the bone she removes from the 2nd metatarsal) to fuse the PIP joint in that 2nd toe to get more pressure off that metatarsal head.

Did you have a very well defined area of callous under that 2nd metatarsal head? I do now and it is surrounded by a more diffuse area of callous. The area of callous was diffuse only at 1st so it took me awhile to determine that the metatarsal head was the problem and my former Dr. was no help until it was too obvious to deny. Even then, he just said it was my metatarsal head and did not refer me to see anyone else who could possibly do anything to help me.

Do you mind me asking what type of Dr. performed your 1st 3 surgeries and what type of Dr. performed your surgery on Tuesday? It would seem that we have similar problems but your metatarsal shortening was more severe than mine necessitating different surgical approaches and I would think a very specialized surgeon. Do you have an idea of how long the lengthening process will take to complete?

I know you are hoping to connect with someone who has gone through this process and by the time I get done posting my long-winded reply perhaps someone who can type much faster than I can will have replied already. If not, you may try doing a search on it. I did a search on "metatarsal lengthening" a few days ago and found a case study in PDF format on one website. The case study described a woman who had to go through a 2 step lengthening process due to extreme metatarsal shortening. In her case, the shortening was due to a bone infection she had as a child but apparently the final results were positive for her.

I am glad you posted your story because it may help someone else out there who is having similar problems after bunion surgery but getting no answers from the Dr. that performed the surgery. We ourselves aren't foot experts but we know when we are having pain and if we try hard enough, we may just find someone who can help us. Even if no one else who has had this lengthening procedure replies, I am certainly interested in following your progress because I have never known of anyone else who had this type of bunion surgery complication or at least no one who was persistent enough to find the right Dr. to diagnose this problem. Take care! Hope to hear from you soon.

 
Old 10-31-2003, 04:20 PM   #3
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faireswearboots,

You are correct. I have been keeping up with your saga. Once I found this board, I read everything I could about bunionectomy procedures that didn't turn out quite right.

My first doctor was a podiatrist. He had a real pollyanna attitude. Kept saying everything was just fine. Several things about him in retrospect make me think he made decisions too quickly and was very interested in $$$$.

The doctor I went to for a second opinion was also a podiatrist. He thought at first that my second metatarsal should be shortened. He conferred with a fellow doctor who felt that there was too much difference for that to be successful. The second doctor sent me to his colleague who is an ankle and foot surgeon (as well as a podiatrist). The third doctor explained what was wrong and was the first one to really make sense to me.

As far as the time involved...I'm not quite sure. A lot will depend upon the time it takes for the bone to fill in. I had the surgery on Tuesday and I go back on Monday for the post op. I expect him to remove the stitches at that visit. I think I will return on Friday to begin the actual lengthening process. Unless he changes his mind, I will turn the internal fixation device twice a day for 10 days. The bone can be extended a millimeter a day. After the 10 days, the fixation device will be stabalized and we will have to wait for the bone to fill in. I will be on crutches during this time.

My doctor wrote a prescription for a Roll-A-Bout which we ordered today. Hopefully, I will be able to get around at school lots better with this. My arms are very sore just from being on the crutches since Tuesday.

When is your surgry scheduled?

 
Old 11-04-2003, 07:36 AM   #4
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First Week After Surgery

Had my post op visit yesterday and according to the doctor everything looks fine. Because he had to put the fixation device through a thicker part of the bone, I have to wait until next Monday to begin the actual lengthening process.

I am still bandaged up to my knee. Foot is still swollen. I'm doing much better with the crutches this time. I think I have gotten the hang of it. Sure glad I don't have stairs to climb. Feeling sorry for my husband who has to drive me everywhere. Folks at school are good to me. Spending more time in my office than I like to. Anxiously awaiting the Roll-A-About.

 
Old 11-06-2003, 04:50 PM   #5
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Roll-A-Bout arrived last night. Used it today and have fallen in love with it. It is so much easier to get around the halls at school with it rather than the crutches or wheel chair. Plus the students all think it is real cool! I'm so glad I read about this on the boards.

My foot is progressing nicely. There is not much pain right now. I imagine that when I start turning the device twice daily that there will be some pain involved. That should only last 10 days. Then I just have to stay off of my foot until the cartilage turns to bone. My hopes are to be in a walking boot of somekind before we go on our family reunion cruise the 13th of Dec.

 
Old 11-08-2003, 07:13 PM   #6
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Hi momtochet,
I have been keeping up with reading the foot problem threads but I have not taken the time to post this past week until now. I have been so incredibly busy trying to get things done before I become "immobolized" once again. I made an extensive "pre-surgery to-do list" and I have accomplished most of what is on my list now. I am not generally one to procrastinate - at least not when I have surgery scheduled.

My surgery is scheduled for 1 week from Monday - on November 17th. I am rather nervous about having yet more surgery on my feet and every once in awhile I feel like chickening out but I would really like to get rid of this pain so I have to try it. A good friend of mine has been giving me "pep-talks" and it is helping. I just can't stand the thought of any more surgical failures. I have been so busy this past week that I am in total agony with these feet by the time evening rolls around.

It sounds as if your new Dr. took the time to really make sure the correct procedure is performed on your foot instead of just jumping right in there to shorten the 2nd metatarsal instead of lenthening the 1st one. What you said also makes me feel even more comfortable with my doctor's decision to shorten my 2nd metatarsal since your 1st one is a centimeter too short and mine is less than half of that amount too short. Anyway, I pray that these procedures work for both of us. Well, keep me posted on how things are going and I will talk to you later.

 
Old 11-09-2003, 05:34 AM   #7
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Quote:
Originally Posted by fairieswearboots
Hi momtochet,
I have been keeping up with reading the foot problem threads but I have not taken the time to post this past week until now. I have been so incredibly busy trying to get things done before I become "immobolized" once again. I made an extensive "pre-surgery to-do list" and I have accomplished most of what is on my list now. I am not generally one to procrastinate - at least not when I have surgery scheduled.

My surgery is scheduled for 1 week from Monday - on November 17th. I am rather nervous about having yet more surgery on my feet and every once in awhile I feel like chickening out but I would really like to get rid of this pain so I have to try it. A good friend of mine has been giving me "pep-talks" and it is helping. I just can't stand the thought of any more surgical failures. I have been so busy this past week that I am in total agony with these feet by the time evening rolls around.

It sounds as if your new Dr. took the time to really make sure the correct procedure is performed on your foot instead of just jumping right in there to shorten the 2nd metatarsal instead of lenthening the 1st one. What you said also makes me feel even more comfortable with my doctor's decision to shorten my 2nd metatarsal since your 1st one is a centimeter too short and mine is less than half of that amount too short. Anyway, I pray that these procedures work for both of us. Well, keep me posted on how things are going and I will talk to you later.
Hi fairieswearboots,

Congratulations for getting things done ahead of time. Two weeks after surgery for me and with my Roll-A-Bout I am at least able to take care of myself....carry my own coffee.

I can relate to your concern about yet another surgery. While mine is behind me I go Monday to learn how to begin the lengthening process. My doctor says it won't be very painful...like getting braces tightened. However, with braces you don't get them tightened twice a day. I'm anxious for tomorrow to get here and yet a little apprehensive.

Maybe you can slow down and do some fun things this week. Please keep in touch. Since one doctor thought shortening the second metatarsal would be the direction for me, I am very interested in how your surgery and post-op time goes.

Judy

 
Old 11-11-2003, 02:24 PM   #8
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Started rotating the device yesterday. Can even feel the milimeter change. My fingernail will fit between two parts of the fixation device. Not too much pain involved.

Fell at school today. Hope I am not trying to do too much.

 
Old 11-11-2003, 03:18 PM   #9
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Hi momtochet,
I am glad to hear that there is not much pain involved in rotating the lengthening device. The device looks absolutely wicked on the pictures I have seen on websites but as long as it does not hurt as much as it looks like it would and it works then that's what matters most. It is amazing that someone came up with that procedure to help people with over shortened bones. Is your device attached to the top of your foot or on the side?

Gee, are we the only ones who have had the complication of an over shortened metatarsal?! No one else has posted on this thread but I guess that is a good sign. I am slowing down the pace this week since I got so much done in the last 2 weeks. I had lunch with "the girls" yesterday and my feet aren't bugging me so much the last few days since I am slowing it down now.

Please be careful! No more falling!!! Reports of people falling are starting to scare me. So far, I never fell with any of my previous surgeries and I don't need to start now! Take care. I'll talk to you later!

 
Old 11-12-2003, 05:41 PM   #10
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fairieswearboots,

I'm about to conclude that the two of us are the only two with this problem. I'm anxious to hear how your surgery and recovery goes.

I may have spoken too soon about the pain involved in lengthening the metatarsal. This morning and evening were more painful than the first couple of turns.

After only 2 1/2 days I can actually see my toe lenghten. What wonders doctors can do today. Sure hope this is the solution to my pain. It would be awful to go through this and still have pain.

Last edited by mom2chet; 11-15-2003 at 04:17 PM.

 
Old 11-15-2003, 04:19 PM   #11
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fairieswearboots,

I know your surgery is coming up on Monday. Thought I would give you an update on mine. I now have 5mm growth in the metatarsal. There is pain involved but not enough to put me out of comission. I don't drive, but have been able to keep up with work.

It really is amazing to watch the toe grow. I go back on Thursday to see how much longer we will keep turning.

Keep us posted about your surgery.

 
Old 11-16-2003, 11:41 AM   #12
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Hi mom2chet,
Yes, my surgery is tomorrow. I can scarcely believe that I am once again counting down the hours! I just need to get this over with, get some pain relief, and get on with my life!!! But I do have to get the other foot redone next spring as well. And wouldn't you know it - no matter how hard you try to plan ahead for things, mother nature sometimes has other ideas! I WILL go through with this surgery tomorrow but one of my pre-molars cracked this weekend (1st time I have ever had a tooth crack) and I am having quite a bit of tooth pain now. I will see my dentist as soon as I am able and someone can drive me there but in the meantime, I will just have to live with the tooth pain as well as the post-op pain.

Wow!!! 5 mm of growth! It must be reassuring to see your toe starting to look like it should look. I am not surprised to hear that there is pain involved but I am glad it is tolerable for you and that you are seeing positive results. I will give an update on my surgery as soon as I can and I will be looking for your Thursday update.

 
Old 11-29-2003, 10:03 PM   #13
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Lengthening of Toe

Quote:
Originally Posted by fairieswearboots
Hi mom2chet,

Wow!!! 5 mm of growth! It must be reassuring to see your toe starting to look like it should look. I am not surprised to hear that there is pain involved but I am glad it is tolerable for you and that you are seeing positive results. I will give an update on my surgery as soon as I can and I will be looking for your Thursday update.
Good news. My toe has been lengthened a total of 12 mm. It is very visable. Now the external fixation device has to stay in place until the bone fills in. I will go back to the doctor on Dec. 12. I'll have to have the device in my foot while I am on the family reunion cruise. I hate that cause I won't be able to snorkle or dance.

I won't know how successful this whole thing has been until I can once again walk on my foot. That seems to be further in the future than I originally thought.

Has anyone else heard of this or had it done?

 
Old 11-30-2003, 07:07 PM   #14
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Re: Lengthening of Toe

This has been a long day. My foot has hurt more today than usual. Probably the result of too much shopping. Going back to school tomorrow should help, I hope. Don't want to continue to be in pain. I think the foot is fine...it's the external device (looks like something you would see in a horror movie) is the cause of the discomfort. Going for more advil.

 
Old 12-01-2003, 08:16 PM   #15
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Smile Re: Callus Distraction....Callotasis

Hi mom2chet,
Up to 12 mm of growth?! I can't imagine how much pain you must have had prior to surgery with a metatarsal that much too short! Mine wasn't near that much too short and I had a lot of pain. But I guess those kind of differences account for the differences in the surgical approach of our respective doctors. What we are going through is bad enough and what makes it even worse is the wait to find out if it will help us when all is said and done. First time I had my right foot operated on was 3&1/2 years ago thinking I would finally get this bunion problem fixed once and for all. I guess I have. It would be safe to say that I no longer have a bunion. What a round-about-way to get rid of a bunion and the associated pain! Well, keep me posted!

 
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