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Foot & Ankle Problems Message Board


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(Quote) I had bunion surgery back in '91 for what they called metatarsus primus varus. My feet were really splayed as well. During those surgeries, they shortened the first metatarsal. Now my second met is more than 1.5 cm longer than 1st and 3rd. My problem is not so much at the head (by toes) of the 2nd met but at the base or the tarsometatarsal joint. There is inflammation there more so than at the head. So I will have a 2nd metatarsal shortening osteotomy and possible fusion of the tmt joint. There is arthritis there and the doc says he will either clean it out or fuse it.
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Wow! Yes, that does sound like we have very, very similar things going on. I had the metatarsus primus varus as well as bunions. I had what was called a "Chevron osteotomy" and was apparently "experimental" at the time (I don't remember that part, but my mom, who went with me to pre-surgical appointments, says that's what the doc said - This doc lost his medical license now about 3 years ago, for performing "Unapproved" surgical procedures! :eek: Guess that's what happend to me :rolleyes: ) My podiatrist said I "probably" had short 1st metatarsal to begin with, but the type of osteotomies that were done (also with bunionectomies) that I had at ages 18 and 19 probably shortened them even more, so the 1st metatarsal is "very short" and 2nd metatarsal is "much too long" and as a result is now bearing most of my weight, rather than the 1st metatarsal, which is supposed to be the main weight-bearer. When you look at the X-ray, you can see that the 2nd metatarsal has thickened so much (from accumulated stress fractures, and from weight-bearing) that it is now thicker than the 1st metatarsal! You can also tell because I don't have any callus or thickened skin under the ball of my foot - it's under the 2nd and 3rd metatarsals instead.

My doc will also be shortening my 2nd metatarsal and putting pins in there, but the fusion thing is for sure (at the base, near ankle, same as yours - maybe I used the wrong term - I was going from memory - I know it's the part of the foot where the 1st metatarsal has it's first joint - way back by ankle, behind/above arch) is for sure, as that is splayed out nearly 45° angle :eek: Now I know why I can never find shoes that fit!! (And why I've been gimping around for the last several months) :(

I'm hoping someone will pipe in that has had this procedure done (the 1st metatarsal joint fusion with pins, and the 2nd metatarsal shortening and fixing with pins). I'm turning into a huge chicken after having 2 very bad experiences with back surgery - I'm actually going to call my family doc this afternoon and ask him if he can Rx some kind of sleeping pill to take the night before surgery (and maybe the couple nights before that!), as I'm very anxious right now.

Thanks for your reply. I will let you know how it goes.
JD





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