Location: Westchester County, New York, United States
Hallux Limitus from Lapidus procedure
Hello All- First off I would like to say that I read some of the older message boards regarding hallux limitus/ rigidus and am very impressed that all of you are such informed patients!!
Now down to business. When I was 15 (11 years ago) I had a severe bunion, which I chose to have surgically corrected by a pediatric orthopedic surgeon. He chose to do a lapidus procedure to remove the bump on the bunion and took a wedge of bone out of the first metatarsal bone at the base to reduce the space between the first and second metatarsals. In addition, a wedge of bone was removed from the proximal phalange in my big toe to straighten that out as well. I had 4 inch long pins in 3 spots to hold the bones together until they healed. The recovery was about 3 months long, and I have been extremely happy with the results.
Recently, I have been trying to get more active and began noticing pain in the joint between the first metatarsal and middle phalanges (toe bone, as I call it). I thought it was the bunion recurring, as I do have a small bump on the side of my foot. The first podiatrist I saw recommended a head osteotomy. I went for a second opinion to another podiatrist, who noted the range of motion in my big toe was limited. Without taking x-rays and only on examination alone, he recommended what I have later researched to be a cheilectomy. I went for a third opinion to another podiatrist, who is more of the non-surgical route, however did take weight-bearing x-rays of my foot and noted I had a Hallux Limitus. He said surgery could help but to be very wise who I chose. He also recommended orthotics, but as a 26 year old, I don't want to have to rely on fancy shoe inserts for the rest of my life!
In reading several message boards regarding hallux limitus, I have noticed several more things about my scenario I hadn't previously. The bunion has recurred ever so slightly, but in addition I noticed the bump on the top of the joint, which I read is common in the Hallux Limitus. I am leaning towards surgery, as like I said I am only 26 and I do not want it to turn into a hallux rigidus. I am nervous in making this decision. Has anyone had a similar situation? Any advice or feedback would be extremely helpful.
Here is my standard advice (and I've had cheilectomies on both great toes). Find a good sports med ortho who is foot and ankle board certified...not a podiatrist. This condition is very common in athletes - aka tennis toe, runners toe, turf toe.
Since you are in the NYC area, there are many good ones who have been mentioned here. Dr.Elliot at the Hospital for Special Sugery is one. Or, you could call the Jets or the Giants and find out who they use. Other people may have additional suggestions.
If you can avoid joint surgery at your age, please do so! There are many good foot surgeons out there, both orthopedic and podiatry. The problem seems to be defined by the old saying, "if the only tool you have is a hammer, then everything looks like a nail."
Find a podiatrist who is well versed in biomechanics as opposed to surgery. I had been wearing orthotics for hallux limitus since my mid 20's with good success for almost 20 years. My running career had been spared until I got into my 50's when I finally opted for surgical treatment.