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Old 02-20-2008, 01:36 PM   #1
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Question NEED TO KNOW APPROX COST- Big toe fusion, or Chilectomy

I am in Florida, USA. Absolutely need either a chilectomey or a fusion of the 1st metatarsal. Bad arthritis at that joint AND at the joint in mid of the toe. I am paying for this out of my own pocket and would love to have a ball park figure for the surgery.- since it will probably be most of my savings I need to know. Assuming no grafts or anything. My doc's office wont even ball park it for me before appointment. The prob is that I dont want to spend 300 for appointment and new x rays- I'm not a wealthy man nor do i have insurance. I already got x rays elsewhere and through my research, surely know I need one or the other- spurs are very obvious as is the arthritis. Stage 3 rigidus. Im 44 yr old male and am extremely sports active (running- 6-10 mi per day was norm, basketball, racketball etc) so I was thinking fusion with what Ive read here and elsewhere. ALL REPLIES are DEEPLY appreciated regarding costs.

 
Old 02-20-2008, 08:49 PM   #2
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Re: NEED TO KNOW APPROX COST- Big toe fusion, or Chilectomy

I can't help with the cost issue but if the cheilectomy doesn't work you may need the fusion down the road anyway. So if you can only afford to do this once the fusion may be the ticket. However, a fusion is a much more invasive surgery and will probably cost more to begin with but at least you will only have to pay the hospital once. But beware, there's no going back after a fusion and you'll have a permanently stiff toe. I hate to advocate a fusion from the get go but if you have arthritis in both the big toe and phalangeal joints it may be the better choice. I think you are just going to have to see what the doctors says and have them run you an estimate for both course of action.

 
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Old 02-21-2008, 03:35 AM   #3
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Re: NEED TO KNOW APPROX COST- Big toe fusion, or Chilectomy

Not sure of the cost, but I do know that if you are paying cash, it's important to ask for price quotes (and discounts) in advance. You do not want to pay the "book rate."

 
Old 02-21-2008, 04:33 AM   #4
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Re: NEED TO KNOW APPROX COST- Big toe fusion, or Chilectomy

You should negotiate the cost with the hospital and doctor by telling them you plan to pay cash. They discount the cost to the insurance companies and will to you if you ask up front.

As to which you should do, only you can answer that once you've seen the doctor.
I had the cheilectomy and it was very successful.

Since you are in St. Pete, call the Bucs front office and ask who they use for "turf toe" problems. That's who you need to see.

 
Old 02-21-2008, 04:50 AM   #5
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Re: NEED TO KNOW APPROX COST- Big toe fusion, or Chilectomy

Antawn, I just had this done in October. Bone came off my hip and was inserted into the first MTPJ, then a plate and 9 screws attached to hold it all together. The first joint at the tip of my toe was left alone, my doc told me that joint still needs that little bit of movement to be able to walk, but the MTP joint is all fused up now, 4 months post op.

I had one overnight in the hospital while recovering which was well-spent, I could have made it two nights and was given that option, but I didn't get a good night's sleep there and wanted to go home.

75K was my total. I live in suburban Philadelphia. The biggest cost was the hardware; 30K was spent on the plate and screws. Good luck with the procedure, I have my own thread going with my experiences, so far I have done very well.

 
Old 02-21-2008, 06:15 AM   #6
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Thanks

Thanks for the replies. It looks as though, through my research, that I can afford neither one at this point. I'm pretty amazed at what it costs. I will stay tuned here to see developments, advice, etc. The last surgery I had for knee cartilage was I think 5500 or so for some arthroscopy. I figured about the same for this. Oh well.

 
Old 02-21-2008, 01:45 PM   #7
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Re: Thanks

wish you could some how get insurance. how much pain are you in?

 
Old 02-22-2008, 09:26 AM   #8
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Re: NEED TO KNOW APPROX COST- Big toe fusion, or Chilectomy

I can walk without pain as long as I bring my leg ahead before flexing my toe up as I approach toe-off. The thing that amazed me is I had never heard of this problem. Was training for a half marathon, running from 6-10 miles a day for a few months. One day my foot felt a little sore, nothing too serious, the next day I did 11 miles and it was sore, the next day did 4 miles, then decided to just look at the toe area and there was the half golfball sized knot on top of the metatarsal in the typical spur spot. I went to get xrays as I thought of a stress fracture. When the nurse practitioner put up the xrays, she went "ohh" and I knew something serious was up. My cartilage is about gone at both joints and spurs ABOUND!!!. I have to be the king of all spur people. The bummer is the mid toe is in addition to it. Spurs and pain at toe off on that joint too. Athletics is the center point of my life, and this is stopping my normal life. After about 6 - 8 weeks, ive started jogging 2-3 miles twice a week with some discomfort, but with an insert and the brooks beast shoes, it has helped and can hopefully give enough joint stability to not make it worse.

Last edited by antawndavison; 02-22-2008 at 09:30 AM.

 
Old 02-22-2008, 01:21 PM   #9
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Re: NEED TO KNOW APPROX COST- Big toe fusion, or Chilectomy

i guess if you can run, you may not need a fusion at all. did the nurse tell you anything about your xray?

 
Old 02-22-2008, 01:29 PM   #10
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Re: NEED TO KNOW APPROX COST- Big toe fusion, or Chilectomy

Not much other than Oh My you have very little cartilage left- which leads me to assume the fusion is the way to go, with spurs removed from mid toe joint. I would love the cheilectomy, but have so little cartilage is my concern. Been doing Gluc/Chond for the 2 months since, so maybe I have improved slightly- who knows. I know the inevitable result though. Just have to try to save the cash or find a kind surgeon or even experimental guinea pig I could be. Thanks for the correspondence.

Tom

 
Old 02-22-2008, 02:14 PM   #11
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Re: NEED TO KNOW APPROX COST- Big toe fusion, or Chilectomy

Don't know why you are assuming the worst here. I had a huge halo of chips on my xrays and my cheilectomy came out great. This is also called runner's toe so as a serious runner you should have heard of it. Very common. They drilled holes in what cartiledge was left in mine and it has reaelly promoted growth. I know some people think that doesn't work but it did for me. Shaquille O'Neal had one when he was with the Lakers in 2002 or 2003.

 
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