It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Foot & Ankle Problems Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 01-31-2010, 06:47 PM   #1
Senior Veteran
(female)
 
Join Date: Sep 2007
Location: Missouri
Posts: 531
stepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB User
Fusion Revision?

To all of my fellow ankle and subtalar fusion friends,

I'm curious about malunions and revisions. I'm continuing to have issues and the thought that I may have some underlying problems like a malunion (not a nonunion) going on has crossed my mind more than once lately.

I would love to hear from someone who had a malunion -did you have pain? if so, where was it? what diagnostic tests uncovered the issue? what was the revision like? how long was the recovery?

Any help you can provide will be appreciated.

Thanks!
Step

 
Old 02-05-2010, 03:04 PM   #2
Senior Veteran
(female)
 
Join Date: Sep 2007
Location: Missouri
Posts: 531
stepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB User
Re: Fusion Revision?

Nobody's had a malunion? I continue to have lingering pain and problems and would like to compare what has been going on with me with someone else's story. Please help if you can - I am really hurting and confused about what is going on.

Thanks!
Step

 
Sponsors Lightbulb
   
Old 10-25-2010, 05:00 PM   #3
Member
(female)
 
Join Date: Aug 2010
Location: Boston, Ma
Posts: 67
Cmj806 HB User
Re: Fusion Revision?

Step,

I don't know if your original question regarding the malunion or non union have been answered. I have the same questions. I am just 8 wks post op from subtalar fusion, calcaneal osteomotry, achilles lengthening and a bone graft. I am feeling burning, stinging pains in my foot around and in incision areas. I am feeling my pre surgical pain as well. I have numerous areas on my foot and leg that I do not feel. My doctor even said i am not healing as aggressively as she'd hoped. I am terrified of having to have my fusion revised

Christina

 
Old 10-25-2010, 08:58 PM   #4
Senior Veteran
(female)
 
Join Date: Sep 2007
Location: Missouri
Posts: 531
stepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB User
Re: Fusion Revision?

Actually, my questions were answered - just not here. I ended up being diagnosed with a nonunion in June (18 months after my subtalar fusion). After my treating os tried diagnosing me with a stress fracture in my heel and casting me for 6 weeks didn't work. Steroid injections didn't work. Orthotics didn't work, so I went for a second opinion.

I honestly thought at that point my joints were just fused at a bad angle or maybe the fused hind foot and fused big toe made it so difficult to walk that I was doomed to a life of pain unless they broke my big toe or something. The second opinion doc (well known in the us) watched me walk and held my foot in his hand for 10 seconds when he said "I'm not convinced your subtalar joint is fused." He went on to say, "I wouldn't do anything about your toe. It's actually fused itself in the perfect position. I'm not mad at that." I thought it was kind of a funny way of saying it. Anyway, he thought he could feel a little motion in it and the last CT scan I had the prior year showed the joint hadn't completely fused yet at that point. He proposed maybe the joint never went on to heal completely.

So I had another ct scan that proved his theory. The subtalar joint had not fused, so I scheduled surgery with him. I had the subtalar fusion revision Aug 16th, so I am a little more than 8 weeks post op. the dr said there was a definite reason I had experienced so much pain - there was a large space in the joint that hadn't even begun to fuse.

Can I ask you a couple of questions about your situation? What was the problem that led to your fusion? Was it flat feet? Is your dr a foot and ankle board certified surgeon? And are you using a bone growth stimulator? I am curious to know why your doc thinks you are not healing at a fast enough pace.

I'd be happy to answer any of your questions. I was really frustrated when the pain didn't subside and then later got even worse, so I can understand what you are going through. frankly, it sucks!

I look forward to hearing from you!

step

 
Old 10-26-2010, 06:47 AM   #5
Member
(female)
 
Join Date: Aug 2010
Location: Boston, Ma
Posts: 67
Cmj806 HB User
Unhappy Re: Fusion Revision?

Step,

Well first of all I do have very flat feet. Back in 2008, (worked as pastry chef and that particular november I worked pretty much 15 hours a day, everyday except thanksgiving) I started having extreme pain in my right foot. At first I didn't think it was anything other than my feet hurting after a long day at work. I always had pain in both feet as soon as i got off them. When I finally listened to my mom, and went to see a doctor I was diagnosed with a ankle sprain, even though i tried to insist the pain was more in my foot. I remember the arch area (or where my arch should be, lol) used to ache so badly. I was given an aircast for ankle sprain and then i stood off it for the recommended 3 days like ER doc said and I went back to work. Well I wore that air cast out, after wearing it everyday, and had to by 2 of my own. After wearing that crappy cast for 2 months, I finally got an appointment with my orthopedic surgeon. By this time the arch of my foot had started to distend outward, making my foot even flatter and noticeably sticking out. She immediately did an MRI and diagnosed 13 stress fractures in my foot and ankle. She put me in the aircast boot (my worst enemy lol) for 6 weeks. I went back to see her and only 2 stress fractures remained, i thought it was all over, boy was i wrong. I was told to remain in boot for 2 more weeks then to transition back to sneakers. I was fine for about a month and then had horrible pain again, worse than before. I went back to see my doctor and there were no stress fractures, but my foot was still deformed looking. It was a very stressful trying time period that followed. I was in extreme pain and it felt like no one believed me. I was prescribed 600 mg ibruprofren for pain and was told to ice and elevate when it hurt. I was sent to numerous doctors doing every blood test known to man and bone densisity scans. In July 0f 2009 I got my first cortisone injection, and a week after I got it the pain went away. Foot still looked horrible but i was able to walk again comfortably. after that first shot i received 4 more. Each shot lasted shorter and shorter. This past June after another MRI my doctor told me that a lot of early onset arthritis had developed in the subtalar joint, she recommended surgery. THere was some talk suggesting a break on the growth plate in my right foot when i was 10 not healing right, maybe it was a contributing factor. The head of the foot and ankle orthopedic department at Mass General Hospital (where I had surgery) automatically gives a second opinion when surgery is suggested and he agreed with my OS's recommendation of needed a subtalar fusion, calcaneous osteotomy, a bone graft for fusion from knee, and achilles lengthening. I was told it was a serious surgery with a painful recovery, but that if it wasn't done by the time I was 35 I need a full ankle replacement ( i just turned 30 the day the second opinion dr suggested surgery). So on august 31 I had the surgery. It was pure agony. I was in hospital for 5 days following surgery. My doctor told me I would have to be NWB for 6 to 8 weeks and then we would start some limited WB around week 9. I was discharged from hospital with crutches, a wheelchair, and a walker. For pain I was prescribed Dilauded. The pain was unbearable. my doc refilled the dilauded 3 times. The first week home I feel twice, both times ending up back in ER for xrays, both times i was told i was fine, the screws looked good. After a week Post op I was back in my OS office to have splint cast changed to a fiberglass cast, then at two weeks my stitches were removed and it was extremely painful, i am embarrassed to admit I pretty much screamed the whole time, I was put back in a cast for the next 6 weeks. Two days after the cast change I was back because my cast was too loose, then another was put on, a week later i was brought into the ER with almost black toes and diagnosed with compartment syndrome from my cast being to tight. I was so swollen I had to go in aircast boot for a week and then back to fiberglass. I left the office that day with a prescription for hydrocodone. at 6 weeks I was supposed to back to aircast boot, but my OS said things looked good but she didn't like the way the xrays looked and because of my pain level i was kept in fiber glass additional 2 weeks. I had my most recent visit with my doctor this past friday, i was put into aircast boot again (hello old friend) was told I was not healing as progressively as she liked and said I would be NWB for another 4 weeks. I am schedule to start PT on Nov 15 and my next appointment with OS is Nov 19. My pain is still bad, and I still do not sleep through night. I have lots of burning and stinging and a lot of numbness. Im sorry if this is all jumbled and full of errors, I had a very bad night and only about 3 hours of sleep. I think I gave you a pretty good history. I just feel Im going to have to have the fusion again. I am around 2 people in my house that smoke heavily, I know my OS said even second hand smoke can delay healing or cause non unions, maybe this is playing a part. I think I am seeing my foot in arch area starting to protrude outward again. If i need a revision I would like my OS to do it as soon as possible, I do not want to fully heal and have it 6 months or a year later. Thank you for reading my horrible foot story...I just don't know what to do now. I am terrified of nov 15 the day I have to start pt and most likely start bearing weight.

 
Old 10-26-2010, 11:06 AM   #6
Senior Veteran
(female)
 
Join Date: Sep 2007
Location: Missouri
Posts: 531
stepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB Userstepbystep89 HB User
Re: Fusion Revision?

Wow! You've really been through a lot with your foot. Dealing with serious pain for this long can really wear on a person. I bet you are feeling frustrated and fed up by now.

What I have learned from this experience is that generally doctors don't consider it a nonunion until it has been 6 months due to the fact that some people heal slower than others and there is no sense in rushing into another surgery if you can somehow get the first fusion to heal.

IMHO, some things you have working in your favor are: your dr is keeping you nwb to help the healing, you had a bone graft which often times helps healing, and you are young.

Something you might consider talking to your doctor about is a bone growth stimulator. I have one and am using it now. Both of my doctors put a lot of faith into them and they are both highly respected in their field.

You also might want to ask your doctor to prescribe some medication for nerve pain. The stinging, stabbing, burning and numbness are normally due to nerves. They are traumatized during surgery - getting touched and moved around really pisses them off according to my dr (those were his exact words he he). I take Lyrica which seems to help and Nortriptyline at night which helps me sleep.

I understand your frustration and your concern - trust me. I hope you are not going to end up with a nonunion, but I am happy to answer any questions you might have.

 
Old 10-27-2010, 09:19 PM   #7
Member
(female)
 
Join Date: Aug 2010
Location: Boston, Ma
Posts: 67
Cmj806 HB User
Re: Fusion Revision?

Step,

Thank you so much for listening to my long injury history, lol. I will talk with my doctor about the growth stimulator and nerve pain meds. Some days I can not believe the pain is so bad. Today was a pretty awful pain day for me. I slipped on some wet leaves while using my crutches and I think I may have pulled or stretched my achilles wrong. one of the main things my doc reminded me again and again to be careful of. I was already having a lot of pain prior to slipping. I was too anxious about getting in my house and getting my foot up, i guess i need to pay more attention!

Christina

 
Old 10-27-2010, 09:21 PM   #8
Member
(female)
 
Join Date: Aug 2010
Location: Boston, Ma
Posts: 67
Cmj806 HB User
Re: Fusion Revision?

Step,

Thank you so much for listening to my long injury history, lol. I will talk with my doctor about the growth stimulator and nerve pain meds. Some days I can not believe the pain is so bad. Today was a pretty awful pain day for me. I slipped on some wet leaves while using my crutches and I think I may have pulled or stretched my achilles wrong. one of the main things my doc reminded me again and again to be careful of. I was already having a lot of pain prior to slipping. I was too anxious about getting in my house and getting my foot up, i guess i need to pay more attention!

Christina

 
Old 10-28-2010, 12:44 PM   #9
Newbie
(female)
 
Join Date: Sep 2010
Location: Auburn, Nebraska
Posts: 5
JannyDianne HB User
Re: Fusion Revision?

Hi, I am 4 months post fusion. I had a tibial/talar/calcaneal fusion on June 17 of 2010. And I'm terrified of a nonunion too! I have very little pain in my ankle or foot normally now. Mostly just when I first stand and take the first steps after sitting down for awhile. What's making me worried is that I have a clicking or a bit of a clunk sometimes when I move my foot or when I'm walking. I asked my surgeon about it two weeks ago and of course we couldn't get it to do it in office and he couldn't feel any movement, so he said that he thought it was probably a ligament catching. I'll have x-rays again a week from tomorrow on November 5th and I'm very anxious to see what they show. I'm still wearing a boot and slowly transitioning into wearing rocker bottom shoes just a bit. Has anyone else has this clicking or clunking happen? If I'm almost pain free, that's a good sign, right? And it sounds like maybe it's too early to know for sure about a nonunion anyway? I'm so glad you all are here. It's good to know I'm not alone!!! Thanks!
Janny

 
Old 10-28-2010, 09:23 PM   #10
Member
(female)
 
Join Date: Aug 2010
Location: Boston, Ma
Posts: 67
Cmj806 HB User
Re: Fusion Revision?

Janny,

I have noticed a weird clicking or popping sensation. I just noticed it day before yesterday. Its odd. It does not happen all the time, but when it does it always freaks me out. It feels like a rubbing sensation inside my foot.

Christina

 
Old 10-29-2010, 09:00 AM   #11
Newbie
(female)
 
Join Date: Sep 2010
Location: Auburn, Nebraska
Posts: 5
JannyDianne HB User
Re: Fusion Revision?

Christina,
Thanks for replying! It is a weird sensation, it doesn't happen with me all the time either, just every so often. I guess we both just have to wait and see. I hope you are doing well today, I keep all on this message board in my prayers!

Janny

 
Old 01-18-2011, 08:21 PM   #12
Senior Member
(female)
 
FlatfootDiva's Avatar
 
Join Date: Nov 2010
Location: San Francisco, CA
Posts: 158
FlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB User
Re: Fusion Revision?

How are you both? How has your recovery progressed? I had a subtalar fusion 14 1/2 weeks ago and I've been walking about a week in a sneaker. When i took the boot off, I was not 100 % weight bearing but about 80%. In the sneaker I had to go back to 2 crutches and on occasion one. ( I also had a ptt repair, tendon transfer and calf lengthening.). The outside of the foot hurts to walk, on the bottom and top and the arch too. Any advice for staying patient? My plantar flexion is good the dorsiflexion kind of stiff but my doc said to wait for doing physical therapy u till I can walk better. My foot feels as if it is not fused level. In other words the outside of the foot tilts down or is inverted slightly. I assume it was intentional. So when I stand on it there's a lot of pressure on the outside bottom and it hurts. It also hurts to let up pressure on it as it springs back down. The metatarsals on the top outer edge hurts also. I assume it's the foot getting used to the fusion. What types of pains did you experience when first walking?

About a nonunion: whEn can it occur? My fusion is nearly completely fused. Is there a chance that it could become a nonunion if it doesn't.completely heal or since it's mostly healed I'm ok?

I have popping now it's from tendons moving across bone and although sometimes it hurts I don't it's anything to be concerned about. I try to stretch the Achilles with hard pressure or massage. It pulls on my heal.

I'm frustrated because I thought this week I'd feel better than last week and that I could see a bit of progress.

 
Old 01-19-2011, 08:37 AM   #13
Newbie
(female)
 
Join Date: Sep 2010
Location: Auburn, Nebraska
Posts: 5
JannyDianne HB User
Re: Fusion Revision?

Hi! I'm doing really well. I'm now 7 months post fusion and walking very well with MBT shoes on. I also have a pair of Finnamic's that are very comfortable, but don't roll through my gate as well. My last x-rays a few weeks ago showed good fusion progress, but surgeon says that only a CT scan would show whether it's totally fused yet or not and he still wants to wait for that. I have a screw that's backed out some at the back of my ankle that we will probably remove within a few more months. I can tolerate it and he said to leave it in as long as I can. My nerves along the outer part of my foot and across my toes have never healed and give a numbed-painful sensation when touched, but I don't notice it when walking. Could your pain on the outside of your foot possibly just be nerves? I also had pain across the metatarsals for the first month or two of walking, but it is gone now. And I almost never have the popping thing happen anymore either. I think this kind of surgery is just a very slow thing to heal from. Keep hanging in there, try to have patience ! My progress hasn't always proceeded at a steady pace, sometimes there would a couple of weeks where nothing seemed to be getting any better, but then one day I would realize that when I looked back a couple of weeks I could tell that there had been improvement! I have kept telling myself to give it a year! But even after 7 months I'm doing so much better, I'm really relieved. Take care sweetie and God bless you!!!

 
Old 01-19-2011, 09:36 AM   #14
Senior Member
(female)
 
FlatfootDiva's Avatar
 
Join Date: Nov 2010
Location: San Francisco, CA
Posts: 158
FlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB UserFlatfootDiva HB User
Re: Fusion Revision?

Thanks for the encouragement! I've seen others talk about the rocker shoes. Can you walk in a conventional shoe or sneaker? Right now I'm using my new balance 927 that I had before the surgery. But the foot is too sore to really walk through the stride and flex it. I looked at MBTs but unfortunately they aren't made large enough for my size 12s. The European 42 isn't big enough and in some shoes the 43 isn't long enough either.

I decided this week to work from home every other day. Last week (my first time working in the office) I went into the office each day and by Friday was in a lot of pain. Then I had to take most of the 3 day weekend to rest the foot. Yesterday I was able to walk around the office and across the street to a drugstore with one crutch but was sore in the foot and exhausted in my shoulders by the end of the day. Today I'm working from home.

It may be nerves on the outside. But I definitely feel pressure on the side and when stretching the foot I can see it's tilted to the inversion side. Also my existing orthotic no longer fits the foot and I'm sure that's part if it.

Did you do physical therapy and of so what kind? So far I'm just flexing the foot gently and the doc said no stretching yet other than from walking.

Appreciate your sharing your experience.

 
Old 01-19-2011, 11:39 AM   #15
Newbie
(female)
 
Join Date: Sep 2010
Location: Auburn, Nebraska
Posts: 5
JannyDianne HB User
Re: Fusion Revision?

Hi again!
I haven't even tried to put on a regular shoe! I guess I should probably try it sometime. I can walk barefoot or with socks, so I'm sure I could walk with a regular shoe, if I had to. When I'm barefoot it is fairly difficult for me to walk. I don't have much flexion in my foot, mostly it's just my toes that bend. My surgeon said I might develop more flex in my forefoot in time.
I'm so sorry you're having pain and pressure in your foot. It would be interesting to hear what your surgeon has to say about that issue, eh? I haven't done any physicial therapy. It was talked about, but he said I was doing as well as I could be expected to and that therapy wouldn't be able to help me do any better! I'm kind of glad about that, tired of going to appointments!!! I'm glad that you can work from home some! I developed an infection that flared up 2 months after my fusion and had to be hospitalized on IV antibiotics after surgery to clean out the wound and remove a screw that was exposed at the bottom of the infected wound. When I went home I had to wear a wound vac for 2 months and couldn't return to my job in a nursing home as an Activity Assistant. They have since rehired me on an as needed basis which I am very pleased with. I don't think I could handle being on my feet all day every day. Good luck with every thing!

Janell

 
Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
Help...exercise after spinal fusion Korie Back Problems 12 11-20-2009 08:09 AM
Big toe joint replacement - is fusion the answer? kathleen-l Foot & Ankle Problems 33 01-17-2009 02:56 PM
Fusion Revisions ms_west Back Problems 0 10-28-2008 08:54 PM
Failed Fusion Bionicwan Back Problems 2 08-25-2008 10:15 AM
FAILED FUSION? How does it feel? babyboomer6 Back Problems 18 11-19-2007 03:56 PM




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Join Our Newsletter

Stay healthy through tips curated by our health experts.

Whoops,

There was a problem adding your email Try again

Thank You

Your email has been added








TOP THANKED CONTRIBUTORS



roxygirl1 (187), Zerk (137), Titchou (135), Hollywood48 (121), Missyluke (121), ginger62 (100), LadyKanner (97), LisaBdot (83), AdkLizard46 (55), janewhite1 (52)

Site Wide Totals

teteri66 (1180), MSJayhawk (1013), Apollo123 (909), Titchou (856), janewhite1 (823), Gabriel (763), ladybud (755), midwest1 (671), sammy64 (668), BlueSkies14 (607)



All times are GMT -7. The time now is 03:09 AM.



Site owned and operated by HealthBoards.comô
Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!