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    Old 11-11-2013, 07:33 AM   #1
    nancybva
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    Toe Fusion Questions

    I had a Cheilectomy in Jan. '12 to remove bone spurs (hallux rigidus) in first metatarsal on right foot. Operation was unsuccessful as I now have no cartillage (bone on bone) and am in more pain than before. I now need to have a fusion. I have researched this subject extensively and have met with several ortho surgeons. My main goal is to be pain free and be able to be very active again. I play a lot of competitive tennis (singles & doubles) year round. I also enjoy skiing in the winter. I have read that a lot of people are able to run again and be active in all kinds of sports, and I understand that the plate/screw placement will be at an angle to allow sports and low heels. My questions surround the surgery and recovery. One ortho Dr. (very well known ortho in NY) says that I will be in a hard cast & NWB for 6 weeks; not able to drive for 8 weeks. Another ortho Dr. (in northern Va where I live), says that I will be off my feet for a week and then be given a boot, which I can remove for driving after a week. I am so confused as to the difference in protocols and want to do what is best for recovery and best for being able to play tennis successfully.

     
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    Old 11-11-2013, 02:12 PM   #2
    Titchou
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    Re: Toe Fusion Questions

    Well, Leyton Hewitt had a cheilectomy last year and still plays tennis so I would think your outcome should be good.

    As for the surgeon, as long as they are both Foot and Ankle Board certified, I'd go with the one I was most comfortable with. I also am facing a fusion (once the cortisone shots don't work any longer). One surgeon I've seen says the usual 4-6 weeks NWB. Another, the one I'm going to use based on recommendations from other orthos whom I respect, says I can walk the whole time but off work 2 weeks and then drive after that and back to work. Hardware would come out later - 6 months or so afterward. I've always prefered more agressive recoveries and they have worked in the past (gallbladder removal and 3 foot surgeries). Hope you find a way to make your decision.

     
    Old 11-12-2013, 05:00 AM   #3
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    Re: Toe Fusion Questions

    Hi Nancy

    I think the different recovery protocols may have something to do with the technology your surgeon chooses. The "old" technology is to use pins that extend out of your toes and are removed later, raising infection possibilities exponentially.

    I had 4 toes -- all but the baby toe -- fused two months ago. The big toe has 2 staple-like devices holding it in place, and the other 3 toes have heat activated clips embedded right in the bones. I was placed in a surgical "shoe" right after surgery and I walked/hobbled on it from the get-go. I was allowed to shower normally at 3 days. I drove and went back to work full-time at 3 weeks (my choice, I could have started earlier). I started wearing a tennis shoe at 7 weeks.

    If you want a third opinion, I highly recommend Dr. Myerson in Baltimore.
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    9/11/13: 4 toe fusions

     
    Old 11-13-2013, 08:49 AM   #4
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    Re: Toe Fusion Questions

    It is interesting to see the different post-surgery protocols. I have another version. I had my right big toe joint fused in October 2009. My surgeon used a plate and screw combo. I was able to heel weight bear from the start as tolerated. I was not able to drive for six weeks. I wasn't interested in driving anyway, because braking would have hurt. (I have a standard so can't use my left foot to brake) I still have the plate and screws in my foot because the doctor said it can stay as long as it doesn't cause problems.

    I walked in a two day, 60 kilometre walk in Vancouver in August 2011. I would NEVER have been able to do that walk pre-surgery. I can wear a wider variety of shoes and my foot feels great. I'm sure I could run or play tennis if I were so inclined.

    I was afraid of the idea of fusing and destroying a joint. I realized that with bone on bone damage, my joint was already destroyed. The toe is at a slight angle that is not noticable to most people. Having this surgery has given me my life back and I think I should have had it done sooner.

    Good luck
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    Old 11-14-2013, 01:44 PM   #5
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    Re: Toe Fusion Questions

    WOW Northwind, 60 km is about 30-40 miles, right? Again -- WOW! I love that, it gives me great hope. I have no great ambitions to play tennis or run marathons, but I truly want to be able to walk distances again -- I'd be happy with a few miles a day so I can reliably travel and see the sights. I likely have more extensive issues than you, but my "new" foot is working perfectly -- have I mentioned how awesome my surgeon is? I haven't started training/reconditioning yet, but I am about ready to start a program, and your success makes me happy. Walk on!!
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    1/18/13: PTT transfer, peroneal longus to brevis tendon transfer, calcaneal osteotomy with medial slide, plantar fascia release
    9/11/13: 4 toe fusions

     
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