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6 months post bunionectomy and I'm still sore

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Old 09-02-2006, 10:10 AM   #1
Join Date: Jul 2006
Location: Lake WInnipesauke, NH
Posts: 63
Prin HB User
6 months post bunionectomy and I'm still sore

I had a bunionectomy in March. I had a Lapidus procedure and an Austin/Keller procedure, whatever that means. I know I had 2 osteotomies and two screws put in there. It must have been pretty major, I was NWB in a cast for 8 weeks. My concern is this - I still have pain in the big toe joint when I walk. I find myself walking flatfooted, usually on the outside of the foot, because the big toe hurts when I try to push off while walking. I know the Dr. also put the joint back up onto the sesamoid bones, I think some remove them sesamoids. The ball of my foot feels "thick" is the only way I can describe it. My big toe doesn't touch the ground unless I flex it down.

I was gonna do foot #2 in December, but it looks like that is postponed - my husband fractured his heel two weeks ago, had surgery last week, and is NWB for 12 weeks. This is a very painful injury, and he is basically stuck flat on the couch for a few weeks. I am now walking around a lot more than I like, and can't really go to the Dr.s until he is more able to be left alone. It's gonna be a LONG autumn. WAAAH!!

Is there anyone out there that had as invasive of a bunionectomy, and is this normal after 6 months? I'm starting to get nervous about the length of time this is taking. Cindy

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Old 09-02-2006, 12:41 PM   #2
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Join Date: Apr 2006
Location: Chicago, IL, USA
Posts: 289
KathJack HB User
Re: 6 months post bunionectomy and I'm still sore

Hi, Cindy. Did you have physical therapy after your surgery? My doctor wanted me bending my big toes a LOT starting only two weeks after my bunionectomies. One of my toes was rather stiff in the early weeks, but it's much more flexible now. (I still try to wiggle and bend them daily 3 & 1/2 months later just to keep them in shape.) I was just wondering if you were in a cast for two months and didn't do PT, if your toe wasn't able to develop the comfortable range of motion it should have? (I had no cast and was walking soon after surgery, but I could not say whether or not my procedure was as extensive as yours.) You might also ask about the screws. I was told that about 25% of patients have problems from them and have to have them removed. I wonder if the thickness you feel could possibly be from swelling? I know that some people continue to have significant swelling for 8 months, and few even up to a year, post-surgery. I'd check out all of the above, especially before getting the second foot done. I'm so sorry to hear about your husband. When it rains, it falls, huh? You guys will have more than enough opportunity to develop extra strength of character this fall-- especially in the area of patience-- but I hope you also get some help from family and friends and some times of rest & recreation. Best wishes, Kathy

Old 09-02-2006, 03:27 PM   #3
Join Date: Sep 2005
Posts: 384
sorefootsophie HB User
Re: 6 months post bunionectomy and I'm still sore

Cindy, The reason you were nwb in a cast for such a long time is the lapidus procedure is an arthrodesis (fusion) of the metatarsal/cuneiform joint. So your doctor would have wanted that joint to fuse solid before you stepped on it. Also the Keller sometimes produces a floppy big toe and maybe that is why your big toe doesn't touch the ground. You can find more information on the Internet about both of these procedures and their recovery times. Some people have a Keller and just end up not happy with the result and go on to fuse the 1st mtp joint. Others are happy with it. I know there was a poster who had a lapidus back in late fall but I haven't seen her post in a long while. I have heard it can be up to a year before things totally settle down. Best wishes to your husband on his recovery and, of course, to you too! Sophie

Old 09-02-2006, 04:28 PM   #4
Join Date: Jul 2006
Location: Lake WInnipesauke, NH
Posts: 63
Prin HB User
Re: 6 months post bunionectomy and I'm still sore

Kathy, Yes, I did have PT, but he never had me bending just the big toe. He showed me ankle strengthening with a band, and gait training, pool work, etc. I think I'm going to sit and practice bending the toe as exercise a few times a day. It hurts a little to do, but I'll start slow. I've been afraid to hurt it, but obviously it's as healed as it needs to be, structurally. I definitely still have swelling, and when I shop, etc., I take Ibuprofen before I go. At night I elevate still, mostly out of habit.

Sophie, I see you've been through a lot, I appreciate your informative advice, unfortunately gained from experience, I'm sure. I've looked up the procedures on the Internet, and most of the info is too technical, I'll try looking up the "arthrodesis (fusion) of the metatarsal/cuneiform joint" and see what I get. I didn't know I had a fusion.

I'm thinking that I want to go ask my Dr., and might get a secong opinion from my husband's. He went an hour from home to a super duper Dr. because his surgery was so extensive both the hospital foot surgeon and my foot Dr. declined and referred him to this other guy, who is quite impressive. If I get to do #2, I may change Dr.s

Thanks for your responses,gotta go, Cindy

Old 09-07-2006, 04:41 PM   #5
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Join Date: Aug 2004
Posts: 22
ekgoal HB User
Re: 6 months post bunionectomy and I'm still sore

A second opinion is probably a good idea.
Usually a Lapidus is NOT combined with a Keller. There is no need.

A Keller is a "joint destructive" procedure where basically the diseased/arthritic portion of the joint is cut out. This is why the toe loses stability.
It is really a procedure that is best suited for older, non-active people that don't ask alot of their feet. People that are candidates for a Keller are NOT people that are candidates for a Lapidus. That is another reason why they are almost never coupled.
An Austin on the other hand is a completely different procedure. It also should not be coupled with the Lapidus because they do the same thing. If the Lapidus is done correctly, there is no need for an Austin.
Likely, though, you had a pure Keller. That would explain the floppy toe.

Another reason not to do a Keller, is that afterwards, the big toe joint doesn't bear weight and can likely cause a stress fracture of the 2nd due to the extra weight in that area. That extra weight can also cause some swelling under the 2nd metatarsal head.

Look for a second opinion and let that opinion do your other surgery.

Old 10-12-2006, 04:30 PM   #6
Join Date: Oct 2006
Posts: 3
smileyface17 HB User
Re: 6 months post bunionectomy and I'm still sore

I had an Austin bunionectomy in March 2006. I am having a lot of pain when I bend my tend around where the screws are. My podiatrist wants to remove the screws. He thinks that something is wrong with the tendons or muscles. I will probably have it done in December.

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