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1st TMT Joint Fusion & Bone Graft - Questions

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Old 04-29-2008, 09:33 PM   #1
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1st TMT Joint Fusion & Bone Graft - Questions

I am new to this board. I found it when googling for information about my upcoming surgery.
Of course I couldn't think of these questions when I saw the Dr., and won't see him again until just before the surgery. I am hoping someone here can help me alleviate my concerns.
He did tell me I will be in a cast for 6 weeks, nwb and then a 'boot' for 4 more weeks. I didn't ask what type of cast it will be?? and what is a 'boot"??
I have bad shoulders (2 surgeries on one, and frozen shoulder on the other) and am really concerned with using crutches. I had a previous surgery on this foot and that was pre-shoulder surgery and found using the crutches excruitiating. I did mention it to him and he mentioned the hand type crutches, but as I have osteo arthritis in my hands I can't think that is going to be easy either.
What is the pain level after the surgery? He said he is going to keep me in the hospital overnight for 'pain management'. I can't take Tylenol 3 so hope there is an alternative once I leave the hospital. I know I don't have a huge pain tolerance.
Althought this is going to be my 12th surgery (various body parts ) I am finding I am really nervous about this one. Maybe it is because I know what it is all about. He did tell me that it will probably a year before I look back and say "what a good idea that was" so I know I am in it for the long haul
OH, does this surgery usually need physical therapy after?
Thanks for any input. It is great to be able to ask questions of those that have been thru it and have first hand knowledge.

Last edited by Patee; 04-29-2008 at 09:35 PM.

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Old 04-30-2008, 05:08 AM   #2
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Re: 1st TMT Joint Fusion & Bone Graft - Questions

For the first week or two, you'll probably be in an open splint, so the foot is immobilized, but the incision gets enough air to heal. Presumably, the cast will be a hard plaster or fiberglass thing up to your knee, like you'd get for a broken bone. (Recovering from fusion is, pretty much, just waiting for bone to heal, after all.)

The proper name for a "boot" is a CAM walker. That is a device with a hard plastic frame around soft padding that holds your foot immobile. Might be described as a soft cast. It's rounded on the bottom, so you can walk by rocking off the bottom instead of moving your ankle. Very important: If you do not have comfortable shoes which are about 2 inches high, get some. I used hiking boots. The boot's sole is thick, and if you walk in one high shoe and one low one, you will start messing up your hips or back. I don't know if he'll put you in a calf-high one or a knee-high one.

Regarding crutches: They are evil. My mother had a broken foot and a frozen shoulder at the same time, and they just gave her crutches. She simply didn't leave home for a month. Look into a "Turning Leg Caddy" or a "Rolleraid." (Those brands are good, a similar-looking product from Invacare is an accident looking for a place to happen.) You might need to use crutches anyway during the "gradually weight bearing" phase, though.

Pain management: They got a lot of good drugs out there. At your pre-op visit, surgeon will generally give you a prescription for painkillers that he thinks appropriate, that you can fill in advance and have waiting for you at home.

Also, you want compression stockings for after the cast comes off. They really help with the swelling, especially once you start walking again. You might want to wear them for a full year.

When he says a year, that means a year to be really right. It'll be mostly right in less than half that time.

Physical therapy: Probably lots.

Oh, where are they taking the bone graft from? Your hip? If they are, you might not be able to use the turning leg caddy for the first little while.

Still, you aren't going to move much for the first week anyway.

Old 04-30-2008, 04:03 PM   #3
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Re: 1st TMT Joint Fusion & Bone Graft - Questions

i think the cast will be be hard and that is a quick time for a cast. the boot will be a walking boot so you should not need crutches.

Old 04-30-2008, 04:15 PM   #4
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Re: 1st TMT Joint Fusion & Bone Graft - Questions

Thanks so much for the info. At least I know what to expect as far as the cast type. I was hoping it would be one of those air type for the first six weeks rather than a plaster cast.
I did have my pre-op already and they didn't give me a script for pain killers. I guess they will give it to me when I leave the hospital.
The crutches issue still bothers me as I hate to be confined and not able to get around. I will check out the other options you mentioned.

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