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Foot & Ankle Problems Message Board


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toe fusion is the final. your toe will never bend and will stick up. you will never be able to wear high heels. if you are in severe pain, have the toe fusion. i did and iam 51. recovery takes a long time, but i think in the end it is worth it. if you are not in pain, dont do it.
Hi Debbie,
I had a 1st metatarsal joint replacement in late May this year and still can't
bend my joint and am still in pain when I walk. My doctor wants to take out
the implant and fuse the joint, but I am very nervous about it. How long did
it take to be able to walk, wear shoes, what height of heel can you wear?
I am 53 and very active - would like to be able to play tennis etc. Basically my sport is ridng horses (competition dressage) which isn't too bad on my foot, but wearing boots is painful at present.
I had a 1st mtp fusion done as well. My [B]toe[/B] still bends but it is the joint[B] within[/B] the toe that bends. The MTP joint does not bend. This fusion takes a long time to heal fully. Most doctors will have you non weightbearing for 8-12 weeks. It can take up to a year for the swelling to completely subside. That being said, when it works you will KNOW it! The first two attempts at fusion on my foot were unsuccessful. I kept at my doctor even when he was convinced that the joint had fused. Finally a CT scan showed otherwise. This time is TOTALLY different! My big toe does not stick up. It LOOKS just like the other foot but the end of the toe is a mm or two off the ground....in other words not noticeable. The end joint does move and can bend down to the ground to stabilise me for one legged balance. I still have sore days but it has only been 16 weeks. I can wear running shoes and when I am concentrating, I do not limp! I can wear sandals. I prefer my Ecco sandals as they have velcro at the toe and ankle straps. So far, I can wear a one inch heel with relative comfort but I am able to get into 1 3/4 inch heels....they just are not too comfortable yet. That will take more time. The joint is normally fused at about 15 degrees. If you really want to wear higher heels, the angle could be increased slightly but that would cause your toe to stick up when you are not in heels!!
To Debbie....I hope I have answered here your questions from the other thread. I am just so happy with the outcome so far [B]this time[/B] with the fusion. Have you had a CT scan to ensure that your joint has fused?

To Lise....Good luck with whatever decision you make. If you have any other questions, I will be more than happy to try and give you my perspective. With regard to boots....you will have to find boots that have a FULL zipper or some other kind of opening. Boots with a low heel would be an option [B]EXCEPT[/B] when the 1st MTP joint is fused and no longer bends, you CANNOT bend your foot in order to slide it into the boot! The big toe will catch on the bottom and your foot will go no farther.

Sophie:angel:
kathleen, what did you decide to do? it is almost 10 months for me. i never thought i would come this far. thw swelling is still there, but i can wear some of my own shoes! at the end of october, iam going to have the metal plate taken out of the toe because it irritating the toe. it should help in wearing more shoes, but i am scared to have surgery again. i still have some swelling. anybody contemplating toe fusion should know all the side effects. riding boots if they have a big toe box should be fine for you. i bet they can customize the boot for you. i am doing all my activities i did before except playing singles in tennis. i am sticking with doubles. i say dont be in pain and make sure you have the best dr and other opinions. please let me know. sophie how can your toe not stick up. mine was supposed to be 15%, but when measured it was 10. i can push the toe down with my hand because the from the bottom of the nail bed to the top is not fused. debbie
Debbie, If you looked at my feet, you wouldn't be able to guess which one had the fusion! Both have scars and both have issues with the joint. One has been fused and the other will have to be fused in the future because I have the same issues with that one. As of now....you would never guess. The toe doesn't STICK UP at all! Yes...there is an angle mtp joint to distal end of toe but it is countered by the opposite angle of the metatarsal from the cuneiform to the mtp joint (this is also known as the height of the arch). Maybe since my arch is high....my toe doesn't stick up. I'm not sure why yours does....maybe you should ask? Also, I see that you are having the hardware removed. It MIGHT be an idea to ask for the CT scan before the surgery so you don't have any surprises! Swelling is one of the signs of a non union. There are posters here who THOUGHT the joint was fused only to find out differently during hardware removal. SoCalSharon....are you around? I think that was you wasn't it? My doctor also said mine had fused...the first time and the second time...I knew differently! Take care, Sophie:angel:
Hello All,
Good to hear the progress. My 2nd surgery was a metal hemi-toe implant in the MTP which had to be removed because it "didn't seat properly". Dr. said a new implant would eventually have to be removed followed by fusion so I chose fusion. I had a bone graft from my hip and mtp fusion in 7/05. I had frequent swelling and redness so my new doc removed the hardware in 4/06 and discovered a non-union which was not visible on an xray and even if we'd waited the full year, it wasn't ever going to heal. In 7/06 he did a "revision" with bone glue he created with bone from my heel. The heel does not bother me at all, but my hip, 2 years later, is still painful often. Apparently, this is not uncommon, so I don't recommend it. The pod who did my revision said he never recommends it for this very reason. 6/07 I had a ct scan which confirmed a union (finally) so in July I had the hardware removed since I had a lot of irritation from it. That was 5 weeks ago today and I'm finally seeing an end to the pain (almost 5 years since my first procedure). The hardware removal was pretty easy comparatively. Just a twilight sleep which I came out of easily, percocet for a week followed by vicodin for a few weeks. The nerve was really angry after being disturbed 6 times ;) . I'm now feeling much better and get my xray next Tuesday so I'll let you know what he says. Regarding the fusions: It's impossible to predict if yours will fail or not and it takes a full year to heal. Be patient or don't chance it. Before my first surgery (at age 42) I had power walked 3 marathons and was really into hiking and mountain biking. Now I'm 47 and have been mostly sedentary as the these surgeries have run my life. Maybe I'll hike this year though :) .
Sharon
hi sophie, my dr will only remove the hardware with a ct scan. there is still some swelling, but i can fit into shoes i couldnt 8 months ago. i guess the ct scan will know for sure. sharon, how long is recovery from the removal of hardware and were you in a cast or surgical shoe? debbie
Well, the jury is still out on how long. It's been 5 weeks and most afternoons I spend elevated still and can only wear a couple of my pairs of sandals. I am doing better though and actually ventured through home depot without the electric wheelchair cart today!! I was in a surgical shoe for about two weeks. Take care. :)
Your situation seems similar to mine. My dilemma is while the smaller implant surgery can fail, I'm told that the bone fusion can fail as well. How long did it take before you were able to wb and get your foot into a sneaker? My last surgery, it took 6 months before I could wear a sneaker. Presently, 10 months after surgery, I am able to wear a sandal. However, I cannot walk for long periods as the pain accelerates. I was out of work for 7 weeks with the last surgery when I was told I would be back at work in 3 weeks. Now I'm being told that if I have the surgery with the smaller implant, recovery will be quicker since he won't be cutting any bone as in the last surgery. From reading messages on this board, people are saying that after the bone fusion they are having hardware removed. What kind of hardware are they referring to. Is it something that is installed while performing the bone fusion? Thanks for your input.
Hi Everyone!

I must say I'm so glad to have found this message board with people who KNOW what I'm going through. I little history about me. I'm currently a 33 year old male who had a Head Procedure Bunionectomy back in June 04'. The results were terrible. First off the doctor told me to walk out of the hospital. I don't know about you guys but I couldn't put a ounce of weight on my food after the surgery. It took weeks somewhere around 6-8 for the swelling to go down. I was never happy with the results of my surgery. My foot hurt so bad that a little over a year and a half I had to have foot surgery again....this time my 2nd surgery was a metal hemi-toe implant in the MTP. Oh my I thought my first surgery hurt like hell. This one was so painful for so long. I had it done in Dec of 05'. I went to my doctor so many times complaining about the pain. I got a cortisone shot in the side of my foot shortly after surgery. I think that was the worst pain I've ever had. Anyway....here I am almost 2 years later and my right foot hurts so bad at times I can't walk really well. My level of activity has really fallen off. I used to rock climb and was advit runner. Both of those days are no long gone. I must say I'm scared of the thought of having another surgery. My doctor has now told me the only thing left to do is to fuse the joint.
Ugh....I can't believe a foot could hurt so much. I've known people with hip replacements who had less pain than what I seemed to have had. Thanks for any support you guys can give me.

Austin
[QUOTE=SoCalSharon;3178159]Hello All,
Good to hear the progress. My 2nd surgery was a metal hemi-toe implant in the MTP which had to be removed because it "didn't seat properly". Dr. said a new implant would eventually have to be removed followed by fusion so I chose fusion. I had a bone graft from my hip and mtp fusion in 7/05. I had frequent swelling and redness so my new doc removed the hardware in 4/06 and discovered a non-union which was not visible on an xray and even if we'd waited the full year, it wasn't ever going to heal. In 7/06 he did a "revision" with bone glue he created with bone from my heel. The heel does not bother me at all, but my hip, 2 years later, is still painful often. Apparently, this is not uncommon, so I don't recommend it. The pod who did my revision said he never recommends it for this very reason. 6/07 I had a ct scan which confirmed a union (finally) so in July I had the hardware removed since I had a lot of irritation from it. That was 5 weeks ago today and I'm finally seeing an end to the pain (almost 5 years since my first procedure). The hardware removal was pretty easy comparatively. Just a twilight sleep which I came out of easily, percocet for a week followed by vicodin for a few weeks. The nerve was really angry after being disturbed 6 times ;) . I'm now feeling much better and get my xray next Tuesday so I'll let you know what he says. Regarding the fusions: It's impossible to predict if yours will fail or not and it takes a full year to heal. Be patient or don't chance it. Before my first surgery (at age 42) I had power walked 3 marathons and was really into hiking and mountain biking. Now I'm 47 and have been mostly sedentary as the these surgeries have run my life. Maybe I'll hike this year though :) .
Sharon[/QUOTE]
I know it's been over a year since your last post, but I'm hoping you will be able answer some questions since I've been told I have a non-union on my big toe.
The POD also wants to do a hip bone fusion? I read where you don't recommend the hip/fusion. If not, what are the alternatives? I had my surgery the 9th of May. My POD told me in August the toe was well and I could toss the boot. Within 2 days, I had pain and swelling. It was over the Labor Day weekend and he met me at his office. The X-ray revealed a broken plate which ultimately revealed a non-union. I then did 63 days of bone stimulator. Last week out of the blue, with no apparent injury I started to swell and have pain again. That's when I was told nothing but more surgery would help. Were you able to find an alternative?
I'm due to have surgery on the 5th of December. Just to satisfy my mind I'm going to see my Ortho today. He did knee surgery in March. I think that has now been a failure also. Probably due to wearing that hideous boot for 7 months.
Linda
Hi Sharon/Linda
Sharon, You have had so many surgeries I had to read you letter a second time to grasp it all. So happy to hear things are finally working out for you. I am 51 and until the last year and a half, despite arthritis in my big toe, I was flat out. After my hemi implant I was still determined and positive and did everything on my own whether I was hopping on one foot, scooting on my butt up and down stairs with my laundry basket or scurring on the computer chair. I am now at the point where I have to admit my foot is not going to get better and my Dr. suggested removing the implant and doing a fusion. It is nice to hear from someone who had the same thing done.The secretary says I will probably get in Dec. or Jan. for surgery. I have not discussed details of the surgery with my Doctor because I was not sure at my last visit if I wanted to go ahead with it. My problem is that I HAVE to get back to work after the operation. Having said that, if a graft is necessary , would you suggest the heel a better place, and any other advice on post op care. Last time I was not given any follow up insturctions. My Dr. said " just use you own footware" well I still can't do that. I cut out the foot of my sons sneaker. I don't know anyone who has had this operation and it was also new to my phisio therapist. I have to admit I am also scared Linda any your situation is so much worse. Sharon, looks like you are our therapist.
[QUOTE=corkeysue57;3794473]Hi Sharon/Linda
Sharon, You have had so many surgeries I had to read you letter a second time to grasp it all. So happy to hear things are finally working out for you. I am 51 and until the last year and a half, despite arthritis in my big toe, I was flat out. After my hemi implant I was still determined and positive and did everything on my own whether I was hopping on one foot, scooting on my butt up and down stairs with my laundry basket or scurring on the computer chair. I am now at the point where I have to admit my foot is not going to get better and my Dr. suggested removing the implant and doing a fusion. It is nice to hear from someone who had the same thing done.The secretary says I will probably get in Dec. or Jan. for surgery. I have not discussed details of the surgery with my Doctor because I was not sure at my last visit if I wanted to go ahead with it. My problem is that I HAVE to get back to work after the operation. Having said that, if a graft is necessary , would you suggest the heel a better place, and any other advice on post op care. Last time I was not given any follow up insturctions. My Dr. said " just use you own footware" well I still can't do that. I cut out the foot of my sons sneaker. I don't know anyone who has had this operation and it was also new to my phisio therapist. I have to admit I am also scared Linda any your situation is so much worse. Sharon, looks like you are our therapist.[/QUOTE]
CorkySue,
I hope Sharon posts again soon. She has been through so much and can help inform us of things to come. It looks like you're going to have the same procedure I am and around the same time. Let's keep in touch with each other.
[QUOTE=debbie g;3798794]i dont know what a fixater is. my recovery went quite well. the swelling actually lasted 2 years! good luck and when is the surgery?[/QUOTE]
Try to imagine a football goal post with the end post fixed in each bone being fused. A fixator holds the bones in place thereby giving them a better chance to mend together. They can be quite painful at times. I had one on my wrist after I crushed it 10 or so years ago. I haven't seen one on a foot before. I guess I'll see on Dec. 5th.
:confused: Hello all. I am a new member who is looking for advice from survirors. I'm a healthy 61 years young housing inspector who is on his feet many hours per day. For several months now I have had serious pain in my my right big toe joint. Being a Vet I recently went to the VA Hospital in Baltimore for an evaluation. xrays show the joint almost closed and the Pod said it looks like surgery is the right answer. He recommends joint fusion and said I'd be out of work for two months. Sounds like several of you have been through the wringer with joint replacements. I am worried about the outcome. How you can walk with the joint fused. Whether the toe sticks up? Lots of questions and looking for advice. I can't afford not to work for an extended period of time. However, as you can probably imagine the pain is getting worse. What do you all recommend.

Wayne:confused:
I am 2 1/2 months post rt great toe fusion. I am back to work, wearing sneakers and some of my regular shoes (clogs, short boots). My foot swells, but I invested in compression socks which help a lot. My toe is raised about 1/8" off the ground, which enables me to walk without limping. The pain is gone, and in general, I am very pleased with the results. I know I need the left foot done, too, and am thinking about doing it in the spring. Has anyone had great toe fusions back to back? Suggestions?
ellen:)
[QUOTE=sanell;3832219]I am 2 1/2 months post rt great toe fusion. I am back to work, wearing sneakers and some of my regular shoes (clogs, short boots). My foot swells, but I invested in compression socks which help a lot. My toe is raised about 1/8" off the ground, which enables me to walk without limping. The pain is gone, and in general, I am very pleased with the results. I know I need the left foot done, too, and am thinking about doing it in the spring. Has anyone had great toe fusions back to back? Suggestions?
ellen:)[/QUOTE]





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