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Foot & Ankle Problems Message Board


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I have had multiple surgeries on both first MTP joints for the last 20 years for hallux rigidus, ending up with revision surgeries with plates, screws and bone grafts on both feet -- right one in July 2008, left in January 2009. I also have high-turnover osteoporosis, which has caused nonunions in all of my surgeries. The right one is nonpainful, so we are leaving it alone, but after five months, I am reduced to a wheelchair because of extreme pain and swelling in the left foot (plate, six screws, my own bone mixed with artificial bone for graft). First, I was treated for infection, including very painful needle biopsy and six weeks of antibiotics. Blood tests show no more infection, but inflammation and pain persist. Two weeks ago, after a month of Forteo and five months of bone stimulator, saw first hint of bone growth toward fusion on x-ray. I'm despondent about the failure of this surgery and its effect on my life. I work as an attorney, and the wheelchair is not making my life easy to navigate. I'm about ready to pull the plug and let my orthopaedist do another revision, even though I know, due to toe shortening, I will need an iliac crest (hip) graft to restore toe length. Help!
[QUOTE=Dordie16;3965914]I have had multiple surgeries on both first MTP joints for the last 20 years for hallux rigidus, ending up with revision surgeries with plates, screws and bone grafts on both feet -- right one in July 2008, left in January 2009. I also have high-turnover osteoporosis, which has caused nonunions in all of my surgeries. The right one is nonpainful, so we are leaving it alone, but after five months, I am reduced to a wheelchair because of extreme pain and swelling in the left foot (plate, six screws, my own bone mixed with artificial bone for graft). First, I was treated for infection, including very painful needle biopsy and six weeks of antibiotics. Blood tests show no more infection, but inflammation and pain persist. Two weeks ago, after a month of Forteo and five months of bone stimulator, saw first hint of bone growth toward fusion on x-ray. I'm despondent about the failure of this surgery and its effect on my life. I work as an attorney, and the wheelchair is not making my life easy to navigate. I'm about ready to pull the plug and let my orthopaedist do another revision, even though I know, due to toe shortening, I will need an iliac crest (hip) graft to restore toe length. Help![/QUOTE]
[QUOTE=Dordie16;3976120][/QUOTE]

Hi, just giving an update. After almost six months of continuous swelling and pain, my orthopedist and I made the decision to call my left MTP fusion a failure due to low-grade infection and start over. I will have another fusion with new plate and screws, new bone graft, and seeding with antibiotic beads on May 12. At some point, you just have to give up and do it over.:dizzy:
A word of caution! I had several failed fusions and revisions on both MTP joints, with a staph infection forcing me to remove hardware even though the bone had not fused. The point is, I spent many months on a Roll-A-Bout, a wheeled scooter that you kneel on and push with your good foot. Overuse of it resulted in a torn medial and lateral meniscus in the knee I was supporting myself on. Yesterday, I had surgery to remove the torn cartilage, and am back on crutchs. The scooters certainly are convenient, but they are not for long-term use!
Hi I am living in hope of one day being able to put on a shoe or more importantly pull on my fins and ride a few waves on my bodyboard. Last September I had my big toe fused because the pain was crippling. A year later after a surgical infection, 10 days in hospital recovering from septacemia, and a long battle to heal the incision, the fusion has well and truley failed. The surgeon took the screws and bone fragments out this week and for the first time in months I can sort of walk without the surgical boot despite there being no fusion. What happens if you leave the foot unfused. I am not at all keen to be laid up for another year!!! I had no chosie with the original surgery and now want to make a good decision about what to do next. Any ideas. Thanks surfjillnot!
[QUOTE=surferjill;4113530]Hi I am living in hope of one day being able to put on a shoe or more importantly pull on my fins and ride a few waves on my bodyboard. Last September I had my big toe fused because the pain was crippling. A year later after a surgical infection, 10 days in hospital recovering from septacemia, and a long battle to heal the incision, the fusion has well and truley failed. The surgeon took the screws and bone fragments out this week and for the first time in months I can sort of walk without the surgical boot despite there being no fusion. What happens if you leave the foot unfused. I am not at all keen to be laid up for another year!!! I had no chosie with the original surgery and now want to make a good decision about what to do next. Any ideas. Thanks surfjillnot![/QUOTE]
I have been living with a non-union for more than a year. I still have the original screws and plate(broken), but no pain. My advice. Even if it's broken, don't fix it unless it's painful. I don't know why my toe didn't fuse. I'm sorry you had all the problems you did, but unless you are having pain, I wouldn't have more surgery. I play golf at least 3 times a week. But...I walk very deliberate, That is to say, I avoid uneven ground, shoes that put undo stress on the toe, and try to limit my time on my feet. I know based on the condition my foot was in before the surgery, I will never be 100%. I'm lucky I don't have to work. But I know if I had to, I could with a few concessions.
I don't see why you can't surf. I've never been able to, but I know how it feels to love a sport and feel you'll never be able to do it again. I was an avid skater, taught step class, Spin, certified to teach Pilates, aerobics, you name it. I still love those sports, but have scaled back the intensity. I started playing golf with my husband a few years ago, and it replaced all those other sports.

Hang in there,

Linda
[QUOTE=surferjill;4113530]Hi I am living in hope of one day being able to put on a shoe or more importantly pull on my fins and ride a few waves on my bodyboard. Last September I had my big toe fused because the pain was crippling. A year later after a surgical infection, 10 days in hospital recovering from septacemia, and a long battle to heal the incision, the fusion has well and truley failed. The surgeon took the screws and bone fragments out this week and for the first time in months I can sort of walk without the surgical boot despite there being no fusion. What happens if you leave the foot unfused. I am not at all keen to be laid up for another year!!! I had no chosie with the original surgery and now want to make a good decision about what to do next. Any ideas. Thanks surfjillnot![/QUOTE]

I went through the same thing -- infection of my fusion with MRSA, months of antibiotics via IV infusion, failure of the fusion and removal of the hardware and some bone. I am electing not to do another fusion right now because my foot is what my doctor calls a "stable nonunion." In other words, there's nothing holding the foot together except scar tissue, but it is holding together as long as I don't put too much pressure on it. I am wearing MBT shoes to avoid pushing off with my big toe and exerting too much pressure. If and when that fails, the next step will be another fusion, but there is little bone and skin left to accomplish that with, and chances are it will fail too, so I'm not in a hurry. I, too, have wondered if I can go indefinitely without another fusion. The next operation will involve taking a piece from my hipbone to fill in where the bone was lost to infection. I have had fusions in both feet that have failed, and have had to have repeat fusions. I'd like to call a halt to this soon!
Hi 53home, my foot is doing very well. The surgery went well, and I spent two weeks at home. I went back to work after two weeks, because I have a job where I can sit. I also had a stool that I took everywhere I went so I could put my foot up. I had a bit of an infection a couple of days after I got the stitches out. A few days of antibiotics nipped that in the bud. I got my surgery report and six week follow-up reports to show my podiatrist in early January. I noticed that there was no sign of fusion happening at the six week mark, so I got another x-ray in January. This one showed signs of a possible bone infection. :eek: So, I had a bone scan which said that in the absence of redness, heat and those signs, it was not likely infection. I had another x-ray a month later, and it showed healing. No infection. YAY!

So, now I am approaching the four month mark. My foot feels awesome. I have been going for walks and I think that helps. I decided to try my orthotics, and I can wear them now. I am glad I did not let the podiatrist cast me for new ones in January. Now that I can wear my orthotics again, I am hoping the plantar fasciitis that has flared up in my left heel will settle down. That foot did not like having to do more than its share of work!

I hope you get your neuropathy settles down. I am sure the water exercise helps with the swelling. I have been thinking about going to water aerobics, but haven't gotten there. It is hard to be motivated to swim in the winter around here. :jester:





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