Hi All, please note that I am not looking for a solution but merely want to know what others have experienced in their journey.
My journey so far: bad oesteoarthritis in the left big toe ball of foot joint. Dec 4 2008 that joint was fused and religiously wore the air cast (when not at home) for full time until January 12th. X-rays show healing nicely according to Pod Doc.
I now have pain in the top joint of that toe, and my pod said it is the tip of my toe (which had hyperextended during the arthritis development) relaxing down again so the tendons are getting stretched, thus the pain. Should settle down 2 months after the air cast came off.
What has been your experience in the recovery process after a big toe fusion from 2 month onwards? Did you still find you needed to be delicate with your foot? I just don't find a lot of information on the web regarding this late in the healing process (most articles I find are for right after the operation).
In November 2008 I had an operation on my left foot - fusion of the 1MTPj (big toe) and osteotomies for all lesser toes. TO fuse my big toe my surgeon used 2 screws. I was in a cast NWB for 6 weeks, then I was allowed to put some weight ('as bearable') on my heel and to wear post-op shoe (which is a surgical shoe). In accordance to my surgeon, my fusion was healing 'nicely', however, on my xRays I can clearly see a prominent straight white joint line. This prominent joint line goes for 3/4 of my fused joint.
It is 3 and half month since my operation. I am still wearing post-op shoe, I am very swollen, I move around using one crutch. I cannot be on my feet for more than 20 min.
My foot feels very very fragile; I cannot imagine wearing any footware other than my post-op shoe. I just wish all this nightmare will be over one day!!
I've just seen my operating doctir (foot surgeon specialist) and he said that all looks well inside. Except that with the swelling on the top of my toe combined with tenderness bending down - but no tenderness on the sides of the tip joint or bending upwards with the tippy bit of my toe -
It looks like a tendon has moved on top of the plate and is literally sawing on the edge when my foot is overworked! yuck.
He suggests removing the plate but only after a minimum of 6 months after operation and dependent on how well the joint is healing.
This is my first time fusion of the big toe (I had forefoot reconsturction, RA). I have 2 screws, no plate. Is it always necessary to remove hardware? SHould I expect another operation to remove screws? - Oh, I have enough depressions and uncertainty already, since my cast was removed 2 month ago. I don't think I can stand another operation...
i had a metal plate and 7 screws and they were taken out surgically. the recover was not bad. i have no idea what they do for 2 screws, but i am sure it cant be that bad. ask your dr what the procedure is and let me know.
I dunno. I'm not an expert - but that won't stop me giving my opinion!
My doctor said that by now (I had my operation December 4th 2008) in March 2009 I should be experiencing walking without so much pain but if I walk too much my big toe that was operated on gets swollen and very painful (electric shooting down the toe).
After an xray 2 weeks ago, the doc said a tendon is sitting on top of the plate slipping back and forth on the plate edge sawing every time my toe stretches. I am considering getting my plate and screws removed in a few months (probably) ONLY because of this reason.
If I weren't experiencing this additional pain I wouldn't even think of doing another operation!
Hope that helps!
Last edited by amandajewls; 03-09-2009 at 10:32 PM.
Thank you for sharing your opinion and experience! I have a couple of questions. My operation was on 20 Nov 08. In addition to fusion of my big toe I also had osteotomies on all 4 little toes (metatarsal heads) and this is because I have lots of Rheumatoid errosions (R Arthritis). When you say that when you walk 'too much, your toe hurts' - but what is 'too much'?? Can you walk now without crutches? What footwear are you able to wear by now? I still have a feeling of 'metal ring' around the base of my big toe, escpecially in the area toward the second toe. I don't think that I can be on my feet for more than 20 min in one go. And I still use one crutch to move around. Could you please let me know, how much/ for how long you can walk now??
Last edited by shell4; 03-09-2009 at 10:53 PM.
Whoa, you had a lot more hardware work done than me Vicky!
I could walk unaided by crutches once I had the air cast on Dec 28th. I've never needed a cane or crutches since then. The air cast came off Jan 12th and I couldn't walk more than 10 minutes slowly - but then I would pay for it with swollen area of operation and electric shocks of pain all night that pain killers wouldn't touch.
I was wearing my sandals thinking they would not put pressure on my foot.
My foot then started hurting so bad I went back into the air cast and wore that for 2 weeks until I finally called the doctor again. I saw him ... Jan 28th.
At this point even with the cast I can't walk more than a slow pace on even hard flooring for 10 minutes without paying with pain.
He said then that the tendon is sawing over the plate AND that I should be wearing really sturdy shoes that:
1. didn't squish my feet tight.
2. wasn't too big in the toe box that I might try and monkey grip with my toes to keep my foot in (like sandles, flip flops).
3. wear open back'd shoes for same reason.
I bought the Keen Hybrid sneakers with shoe strings and now I can walk briskly (still slowly compared to my 6 year old) up and down hills for 20 minutes. I will still have a sore foot later on, but not as bad as before. The better, more sturdy shoe-wear that keeps my toe from bending wrong really helped. I'm also more mindful of how I place my foot too.
I am almost exactly three months post-op from having my big toe fused. I had the surgery on Oct 28, 2009. It has been a pretty smooth process. I can walk and stand for long periods of time now. I do need to elevate it after longer periods of time down, but it is pretty good. My last x-ray revealed signs of possible bone infection, and I had a bone scan. It was a scary time, but it turned out to be okay. My doctor and I will be continuing to monitor it by x-ray until it is healed. I already have less pain than before the surgery and am very happy about that.
I have a plate with five screws. I was able to heel weight bear immediately, according to pain level. I did have crutches for when the pain was too much, or for extra support when outside in the snow. I was able to fully weight bear and drive at six weeks.
Life is too short to wear tight shoes. ~ May you have happy feet in 2013.
Hello! It's been 1 year and almost 2 months since my operation and I haven't looked back since!
Once I bought the sturdy good solid shoes (Keen!) my recovery sped up very quickly. To date I still prefer not to walk on uneven paths like in the bush where there are lots of rocks and roots to walk over as this makes my foot sore afterwards but... I can walk for hours and hours without pain now!
I am so happy after all and am very glad I did the fusion. The tendon sawing back and forth went somewhere - don't know where but it's gone and I don't have any aches or pains.