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Austin-Youngswick decompressive osteotomy

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Old 01-18-2011, 08:03 PM   #1
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Austin-Youngswick decompressive osteotomy

Originally Posted by misfish90 View Post
You sound just like I did 2 years ago. Like you, I managed with orthotics and sensible shoes for 7 years while still a stage 2. But this is a progressive condition and it eventually got worse. So when I jumped over to stage 3 and it really started impacting the way I lived, I knew it was time for surgery.

I'm now 21 months post-op and doing well. Is the toe perfect? No, but it's absolutely better than before. I had high hopes of returning to my pre-HL days but alas I only got back to a late stage 1/early stage 2. But heck, I managed that for years so if nothing else, it bought me more time and maybe a long term cure (fingers crossed big-time here especially as I'm only in my mid-30's.)

One thing I will say is that recovery is a LONG process so be realistic. I got back to 75% fairly quickly after 4 months. It's that pesky 25% that seemed to take forever. I venture to guess that my foot didn't feel truly "normal" again until I hit the 13 month mark. But people do heal differently.

My recommendation: If you're now living your life around your foot rather than just managing it, then it's time.

MissFish, I was just reading some of your threads. I'm scheduled for chilectomy and osteotomy with a pin, plus dissolvable sutures on the 26th of Jan. (a week from tomorrow) I am now however wondering if i'm acting prematurely. I have the mechanical defect (high first metatarsal) and my pod said if we did only the chilectomy the spurs would grow back bc what is causing the joint jamming is the higher level of the bone. I understand that.

This "injury" occurred in 2008, so it will be 3 yrs this summer. But the bone spur has grown to where I cannot even wear heels without discomfort. The only shoes I can wear anywhere are tennis shoes and even after 30min-1 hour of a walk my foot is sore and inflamed (on the top, from the bunions rubbing agains the shoe, and inside the joint, feels like its on fire). I ice, wear orthotics, elevate all the time. So, I walk less. I dont dance anymore. I manage it, but i am also in a way living around my foot. I will turn 37 next month. (In a way I wish I were older bc i would not have the prospect of running around after my future children ahead of me with a bum foot!)

But I"ve read online also that people suggest not doing this unless or until you have debilitating pain. I can walk. But not on an incline and not really with heels above 1/2 inch w/o discomfort. This hallux lim was brought on by an injury (altho i have the bone structure for it) other words my other foot has it but it hasnt presented with symptoms yet and i have full ROM there.

My goal in doing this was to preserve the cartilage i have left (to avoid fusion or implant later). Is there a reason that, since i can walk now, i should really juts wait until this gets worse? Its such a gamble against the unknown future. I was 100% confident after walking away from the pod's office. I just read these threads (was looking in fact for info on the healing time for my surgeries, what to expect) and now am totally freaked out. Sorry - do not want to hijack the thread but wanted to comment on what you'd written above.

p.s. curious if you could walk easily at 8 weeks post-op in a roller bottom tennis shoe, for say 1 hour per day?

Last edited by Former_Dancer; 01-18-2011 at 08:07 PM.

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Old 01-21-2011, 08:05 AM   #2
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Re: Austin-Youngswick decompressive osteotomy

Former Dancer,
Read my previous post a few below this one. I had my surgery 3 years ago now and am glad I did. My toe is not like the one on my other foot, but it is much better than it was pre-surgery. The ROM is not as good as the other foot, but I can do anything I want to do. The biggest plus is that I do not have the sharp, excruciating pain when I walk up hill. If I wear supportive shoes - either Birkenstocks or other sandals with an arch support or athletic shoes with orthotics - I am virtually pain free. I do wear other shoes occasionally for short periods of time, but get an ache at the point of the osteotomy. It goes away with the right shoes.

You'll see if you read the thread below that I was wearing a shoe at 4 weeks and walking with no problem about 8 weeks after.

My pre-op pain was only when I walked up an incline. I was surprised that my cartilage loss was as great as it was. So for that reason, I am glad I had the surgery when I did. My doc drilled holes in an attempt for the bone to make a cartilage-like substance to provide more cushioning to the joint.

I hope you decide to go ahead with the surgery. Good Luck.

Last edited by SCYogini; 01-21-2011 at 08:07 AM.

Old 01-23-2011, 09:52 AM   #3
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Re: Austin-Youngswick decompressive osteotomy

Thanks so much SCYogini. I am going thru with the surgery, it is on this coming Wednesday, 3 days away. A bit nervous but also glad at the prospect of solving this problem. Yesterday i attempted to wear and walk a short way in flats that I had bought 2 sizes extra large 2 years ago when this "injury" happened for me. Bc of the bone spur growth, those shoes are now too tight on the top of my foot and i could not step without pain. I was also walking on the outside of my foot. It's not good. Go figure.

I had another question -- is your incision on the TOP of your foot? My dr said mine would be, but one of the orthos i had consulted said she would make the incision on the SIDE of the foot. i thought "oh how nice" but now i'm wondering if that is EVER done and if one is better than the other in terms of the Surgeon's ability to get in there and do what they need to do (??) Anyone? Of course i'd prefer a scar on the side than on the top of myfoot but i wouldnt tell a chef at a 5 star restaurant how to cook...

Last edited by Former_Dancer; 01-23-2011 at 09:53 AM.

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