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Old 02-25-2009, 02:46 AM   #1
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shell4 HB User
Question RA forefoot reconstruction - what to expect?

Dear all,
Three months ago i had forefoot reconstruction surgery for my left foot.i have rheumthoid arthritis for 18 years. My operation involved osteotomy of MTPs for all lesser toes and a fusion of 1MTPjoin (big toe fusion). I had K-wires (pins) inserted in all of my lesser toes to straighten toes (pins were removed at 6 weeks) and my big toe has 2 screws . I was in a cast Non-Weight-bearing for 6 weeks; then in post-op shoe for indefinite time partial heel weight bearing (I am still wearing post-op shoe and I am still using crutches, and this is at 3 months post-op!1). This operation was the first ever operation on my foot. Later I've learned that fusion is actually used as the last resort, when other procedures failed... Well, for me it was done in the first round! It is too late now, what has been done cannot be undone and I should be doing my research BEFORE the operation not after...I believed the first opinion and didn't seek second opinion (the surgeon who operated me, ensured that i will be able to play tennis with fusion, so I should be taking it easy) And how naive I was to believe him! During the last 3 month (after the surgery) I've had lots of uncertainty about the future, pangs of depression, pain, swelling....and not a single positive thought about a successful end of all this nightmare. I know that this is not right attitude, but... that is how I feel. I am still totally unsure what is actually expected at 3 months? What is normal?? what level of pain is normal? what footware is 'normal' at 3months post-op? how much a 'normal' patient is supposed to be able to walk? is it normal to use crutches?? And how a fusion, which is healing 'normally' should look on xRays? On my last xrays (11 weeks post-op), i can see a very prominent joint line - it looks like a straight cut of the bones; I cannot see any 'black' gaps between the two bones, but i cannot see any 'fuzzy' staff either. Just two bones with white joint line in between. My surgeon is not very helpful with all these questions; I can ask question only (and stricktly) by booking an appointment with him, for which I have to wait for days/weeks.
I would appreciate if you share any of your thoughts, experience. I also have another post on this forum, 1mtpj fusion - big toe, but, unfortunately, nobody has replied my last message as yet.
thank you in advance.

Last edited by shell4; 02-25-2009 at 02:59 AM.

 
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Old 04-10-2011, 06:17 AM   #2
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sausage172 HB User
Re: RA forefoot reconstruction - what to expect?

Quote:
Originally Posted by shell4 View Post
Dear all,
Three months ago i had forefoot reconstruction surgery for my left foot.i have rheumthoid arthritis for 18 years. My operation involved osteotomy of MTPs for all lesser toes and a fusion of 1MTPjoin (big toe fusion). I had K-wires (pins) inserted in all of my lesser toes to straighten toes (pins were removed at 6 weeks) and my big toe has 2 screws . I was in a cast Non-Weight-bearing for 6 weeks; then in post-op shoe for indefinite time partial heel weight bearing (I am still wearing post-op shoe and I am still using crutches, and this is at 3 months post-op!1). This operation was the first ever operation on my foot. Later I've learned that fusion is actually used as the last resort, when other procedures failed... Well, for me it was done in the first round! It is too late now, what has been done cannot be undone and I should be doing my research BEFORE the operation not after...I believed the first opinion and didn't seek second opinion (the surgeon who operated me, ensured that i will be able to play tennis with fusion, so I should be taking it easy) And how naive I was to believe him! During the last 3 month (after the surgery) I've had lots of uncertainty about the future, pangs of depression, pain, swelling....and not a single positive thought about a successful end of all this nightmare. I know that this is not right attitude, but... that is how I feel. I am still totally unsure what is actually expected at 3 months? What is normal?? what level of pain is normal? what footware is 'normal' at 3months post-op? how much a 'normal' patient is supposed to be able to walk? is it normal to use crutches?? And how a fusion, which is healing 'normally' should look on xRays? On my last xrays (11 weeks post-op), i can see a very prominent joint line - it looks like a straight cut of the bones; I cannot see any 'black' gaps between the two bones, but i cannot see any 'fuzzy' staff either. Just two bones with white joint line in between. My surgeon is not very helpful with all these questions; I can ask question only (and stricktly) by booking an appointment with him, for which I have to wait for days/weeks.
I would appreciate if you share any of your thoughts, experience. I also have another post on this forum, 1mtpj fusion - big toe, but, unfortunately, nobody has replied my last message as yet.
thank you in advance.
Hi - I have had rhumatoid arthritis for several years and am due to have a forefoot reconstrucition in the next few weeks. Fusion plus metetarsal head surgery. I am interested to know how you are doing now? Can you walk normally without pain, can you wear a small heeled shoe on special occasions and are you pleased you went though it all now? Best wishes

 
Old 04-10-2011, 08:41 PM   #3
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shell4 HB User
Re: RA forefoot reconstruction - what to expect?

Quote:
Originally Posted by sausage172 View Post
Hi - I have had rhumatoid arthritis for several years and am due to have a forefoot reconstrucition in the next few weeks. Fusion plus metetarsal head surgery. I am interested to know how you are doing now? Can you walk normally without pain, can you wear a small heeled shoe on special occasions and are you pleased you went though it all now? Best wishes
hello, by now I actually have both of my feet reconstructed. My first surgery (when this blog was initiated by me) was performed 2 1/2 years ago and it was not very successful. I still need to have some corrections (another surgery) for my 4th toe because the metatarsal wasn't aligned properly for that toe; in addition, some of the nerves were damaged... All this was due to the careless attitude of the surgeon... However, a good thing is that I don't have much trouble with the fusion site - it has healed quite OK.

At this point in time I am 5 month post-op with my other foot (the same procedure on my right foot) and this time the surgery was performed much more accurate; by now I can walk for 30 -40 min (still heavily limping) and my foot is not that much swallen. Fusion site is fine.

Both my feet are NOT pain-free. But it is a different kind of pain now - I feel that my feet are constantly burning; burning sensation at all the time, as if I am walking on a small knives.. I cannot walk for long periods without having a rest (sitting down, feet up).

Regarding shoes with heels - since my first operation (left foot) I have been scared to try any sort of heels at all. But before, in my pre-surgery life, I used to wear 5 cm + heals all the time, even just prior to my first surgery. Now I don't even dare to think about heals.

However, I don't exactly regret doing the surgery - this is probably due to the fact that I didn't really have any choice in this matter as my feet did look awful. At least now they look more or less normal...
My advice would be: - 1. do surgery only if it is completely necessary and 2. choose your doctor carefully.

All the very best
shell4

 
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