foot health forum  
Discususion and Information on Foot Problems

Go Back   Foot Pain & Foot Health Forum > Main > Ask your questions here

bone fusion

Reply
 
Thread Tools Display Modes
  #1  
Old 16th November 2008, 11:35 PM
Unregistered
Guest
 
Posts: n/a
Default bone fusion

I'm 22 and female and 2 and 1/2 years ago I was recommended by the consultant at the hospital to have an operation on my big toe as it was being overlapped by the 2nd toe. I wasn't in alot of pain, just a bit and had some discomfort. But I was advised to get it done now while I am young so as to avoid further problems later on in life eg arthritis. In general the op went fine...they took a chunk of bone from the side of the big toe just above where it joins to the ball of foot area. I was on crutches for 7 weeks but there were no problems at that point.

In the past 6-9 months I have been experiencing quite alot of pain and discomfort around the joint, causing me to walk on my 4 other toes or just on the ball of my foot. I physically cannot curl my big toe and find it painful to stand on tip toe. After a couple of doctors visits I was referred to a podiatrist at the hospital. The consultant I saw there was shocked that I had had a bone fusion (not a term I'd had mentioned to me before) at 19, and said these should only ever happen as a last resort if you are in considerable pain and discomfort (which I was not). He took a look at the way I stand and noticed my leg had started to bow from where I have been walking on the left of my foot. He then proceeded to tell me that because I have had a bone fusion I have basically lost the use of my big toe for walking and said "unfortunately this sometimes happens and is a down side to having this kind of surgery." He said my only option now is to either have special footwear (as a last resort) or to have orthotics made, which he is going ahead with.

Firstly if this is true I am shocked I was not made aware of this is in the first place, and secondly now that I am having orthotics made does anyone know if I can get these on the NHS or will I have to pay? Has anyone had a similar experience or can advise me on whether what I have been told is accurate or not?

Thanks
Reply With Quote
  #2  
Old 17th November 2008, 04:36 PM
FootDoc FootDoc is offline
Member
 
Join Date: Jun 2008
Posts: 3,154
Thanks: 0
Thanked 120 Times in 99 Posts
Default Re: bone fusion

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
************************************************** *********
I don't know what circumstance at age 19 might have indicated what you seem to describe was a fusion of the metatarsal-great toe joint. Unless you were seriously mis-treated, there would seem to be a big chunk of missing information here. I really think that it would be unwise for me to otherwise comment on your situation in view of what I suspect is totally inadequate information on my part.
__________________
Foot Doc
Reply With Quote
Sponsored Links
  #3  
Old 17th November 2008, 07:45 PM
Unregistered
Guest
 
Posts: n/a
Default Re: bone fusion

************************************************** *********
I don't know what circumstance at age 19 might have indicated what you seem to describe was a fusion of the metatarsal-great toe joint. Unless you were seriously mis-treated, there would seem to be a big chunk of missing information here. I really think that it would be unwise for me to otherwise comment on your situation in view of what I suspect is totally inadequate information on my part.[/quote]


I have said all the information I have ever been told - I went to the doctors originally, was referred to a consultant at the hospital who advised me to get the operation done even though he knew I was not in a huge amount of pain, just that I had a fair bit of discomfort and some pain. I cannot remember the name of the procedure but he never mentioned anything to me about bone fusion and what that really involves, or that I might possibly end up in the predicament I am in now. If I had been aware of this there is no doubt about the fact I would not have gone through with the operation. As mentioned in the original post - the first time I had heard the words 'bone fusion' was when the podiatrist told me a couple of weeks ago that thats what I'd had done and that thats the reason I'm in the situation I'm in now.

Do you mean that maybe the podiatrist is incorrect? What other big chunks of information did you mean were possibly missing?
Reply With Quote
  #4  
Old 17th November 2008, 08:11 PM
FootDoc FootDoc is offline
Member
 
Join Date: Jun 2008
Posts: 3,154
Thanks: 0
Thanked 120 Times in 99 Posts
Default Re: bone fusion

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
************************************************** *********
What I mean is missing is that there are just too many circumstance which, without some clarification, simply don't add up. First of all, although not unheard of, it is an unusual bunion deformity, which at a mere 19 years of age has progressed to the point where the 2nd toe is overlapping the great toe, especially with the patient's denial of having gone through at least a period of substantial pain, much distress, severe shoe-fitting problems and the like. Secondly, though it appears by your mention of NHS that you are from either the U.K. or Canada, and I don't know what is expected of doctors outside of the U.S., to subject, especially a teenage patient, to a non-functional fusion procedure without much explanation, extensive cautionary statements and the offering of alternative choices, and having that procedure subsequently leave one in the distress which you suggest, would have American mal-practice attorneys rubbing their hands together in glee. Unless your system and typical patient expectations differ greatly from what I am use to, it would thus be my conclusion that there must be either a mis-statement of the facts and nuances of the case or pertinent facts are grossly missing. If neither is the case, I really don't know what to say.
__________________
Foot Doc

Last edited by FootDoc; 17th November 2008 at 08:15 PM.
Reply With Quote
  #5  
Old 17th November 2008, 08:43 PM
Unregistered
Guest
 
Posts: n/a
Default Re: bone fusion

I had had some discomfort and problems getting shoes that were comfortable, but not to the point where it was unbearable. I may have had a slight bunion but nothing particularly noticeable, and once again the consultant never mentioned anything about this, he only ever mentioned the toe. The problem as a whole seems to be hereditary as both my mother and her father had overlapping toes.

Sorry, I failed to mention that I am from the UK, but I cannot imagine that the way of dealing with medical procedures should differ to that of the US should it??

I'm sorry that I do not have any further information to give you, but as I said previously I am only repeating all I have been told.
Reply With Quote
  #6  
Old 17th November 2008, 10:49 PM
FootDoc FootDoc is offline
Member
 
Join Date: Jun 2008
Posts: 3,154
Thanks: 0
Thanked 120 Times in 99 Posts
Default Re: bone fusion

It was not my intent to suggest that the way we deal with PROCEDURES is different in the U.S., but that, if your story is typical in respect to your lack of knowledge as to what you were going to have done and what the risks and consequences might be, the way the PATIENT is dealt with is far different there.

Now, it is entirely possible that, just as here, some patients don't hear or don't want to hear what was said, or don't listen intently, or don't ask questions, and, in spite of the doctor's sincere attempts to educate and inform the patient, he/she comes away with nothing other than that some sort of surgery will be performed. Clearly, I am not accusing you of being in that group, but I am only making suppositions, as I must, in attempting to answer most of the questions to which I respond. But I am now additional confused by the fact that, although you state that the rather radical bone surgery was performed on the great toe, the bunion deformity was only slight and apparently, then, you are saying that it was the 2nd toe father than the great toe where the deformity took place. Sorry, but your word picture is confusing, and I don't think that I can be of help to you.
__________________
Foot Doc

Last edited by FootDoc; 17th November 2008 at 10:51 PM.
Reply With Quote
  #7  
Old 18th November 2008, 05:44 AM
Unregistered
Guest
 
Posts: n/a
Default Re: bone fusion

Unfortunately, 1st mpj fusion by orthopedists is common in the UK, Australia, and New Zealand, even with a healthy joint. Also, the tradition of Public Health and virtually no malpractice problems supports the practice. Informed consent is nothing like in the US.

The great toe is dorsiflexed 15 or 20 degrees, but never works again. There is no toe purchase, balance is affected, walking up hills or taking large strides is a problem, and high heels are out of the question. The joint is fused, and the hallux valgus never returns. Success!

Basically, a greater deformity is surgically substituted for a lesser deformity. But, it's a simple procedure, easily and quickly done.

If you think that is backwards, you should see the lesser toe amputations for hammertoes!

Regards

Foot Surgeon
Reply With Quote
  #8  
Old 18th November 2008, 07:20 PM
Unregistered
Guest
 
Posts: n/a
Default Re: bone fusion

Foot Doc - I understand what you mean now - yes its quite possible that the way the patients are dealt with differ between countries.

Sorry I didn't explain properly what I meant about the toe concerned - it IS the greater big toe that has the deformity as the bone was bent, meaning that it went underneath the toe next to it. Even so, as I mentioned the bunion was only slight, not the size or problem you would expect.

Does that make more sense? Sorry to confuse you.
Reply With Quote
  #9  
Old 18th November 2008, 09:04 PM
FootDoc FootDoc is offline
Member
 
Join Date: Jun 2008
Posts: 3,154
Thanks: 0
Thanked 120 Times in 99 Posts
Default Re: bone fusion

DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
************************************************** *********
As so often is a complicating factor in a forum such as this where words and terminology are the only means of information exchange, in my world, when the severity of a bunion is mentioned, it is generally in terms of the degree of hallux valgus and metatarsus primus varus rather than the size of the bunion "bump." Bunions which only present as a bump on the head of the first metatarsal are generally termed "simple bunions."

Additionally, I failed to comment in my last post in response to your statement that "1st mpj fusion by orthopedists is common in the UK, Australia, and New Zealand, even with a healthy joint." If that is true, it WOULD then indicate that the choices of surgical procedures in such cases there are vastly different from in the U.S. Without extenuating factors which might justify it, I would personally generally consider the correction of a bunion which presents with no joint structure pathology by fusion of a 1st metatarso-phalangeal more than bordering on malpractice.
__________________
Foot Doc
Reply With Quote
  #10  
Old 18th November 2008, 11:40 PM
Unregistered
Guest
 
Posts: n/a
Default Re: bone fusion

Quote:
Originally Posted by Unregistered View Post
Unfortunately, 1st mpj fusion by orthopedists is common in the UK, Australia, and New Zealand, even with a healthy joint. Also, the tradition of Public Health and virtually no malpractice problems supports the practice. Informed consent is nothing like in the US.

The great toe is dorsiflexed 15 or 20 degrees, but never works again. There is no toe purchase, balance is affected, walking up hills or taking large strides is a problem, and high heels are out of the question. The joint is fused, and the hallux valgus never returns. Success!

Basically, a greater deformity is surgically substituted for a lesser deformity. But, it's a simple procedure, easily and quickly done.

If you think that is backwards, you should see the lesser toe amputations for hammertoes!

Regards

Foot Surgeon

Foot Surgeon - Thankyou for your comment as quoted above. While I appreciate that this is common practise of the UK, is it not absolutely necessary to inform the patient that they are likely to lose the proper use of their toe if they are to go through with the operation in question?? I fail to see how doctors/consultants are able to continue this way - performing these procedures without the patient being fully aware of the possible negative outcomes? It almost seems slightly unethical.

FootDoc - Many thanks for your help and information, I now have a much better understanding
Reply With Quote
  #11  
Old 19th November 2008, 08:09 PM
Unregistered
Guest
 
Posts: n/a
Default Re: bone fusion

Dear Foot Doc

I agree. But without competition, and in socialized health care there is none, surgeons are able to behave as they did in the past in the US. Witness some of the things that happen in the Kaiser Permanente system where patients give up their right to sue.

The care may not be substandard, but it's second rate.

Cheers

Foot Surgeon
Reply With Quote
  #12  
Old 20th November 2008, 10:24 AM
Unregistered
Guest
 
Posts: n/a
Default Re: bone fusion

Foot Surgeon - that previous comment was from me, not Foot Doc! Thankyou for your comments, I guess its just something we have to accept differs between countries, not that that makes it right.
Reply With Quote
  #13  
Old 29th March 2011, 02:04 PM
Unregistered
Guest
 
Posts: n/a
Default Re: bone fusion

I'm an 18 year old female and I am hyper mobile. I get a lot of problems with pain in my joints and am in and out of hospital all the time. Nearly 3 years ago now I had a bone fusion on my 2nd toe in my right foot to correct a hammer toe. This worked for a while though i lost all feeling in the tip of my toe.
3 years down the line and I've just been told today that I need another bone fusion done on the 2nd joint in it as my toe has tried to over compensate for the loss of movement in the top joint and has now bent completely under itself. After much debate, a lot of physio and many x-rays they have finally decided to operate again as too much pain is being caused. I had everything from insoles etc all on the NHS.

Bone fusions aren't always successful, yet my surgeon failed to mention the risk of it going straight back to it before I had the surgery. Now I have to have corrective surgery in order to fix what they did in the first place. Also the aftercare from the operation was horrendous. I was made to walk out of the hospital in complete agony having just had my toe broken, bone removed, set and pinned just half an hour after waking up.

In experience take all they say on board and just research a hell of a lot before listening to them.
Reply With Quote
Reply

Bookmarks

Tags
None

Thread Tools
Display Modes

Posting Rules
You may post new threads
You may post replies
You may post attachments
You may edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
bone growth on outside of foot Unregistered Ask your questions here 5 12th April 2012 10:48 PM
Gorham's vanishing bone disease Admin Podiatry Arena 0 28th June 2008 12:45 AM
bone spur in a 10 year old Unregistered Ask your questions here 2 26th June 2008 10:12 PM
Heel bone pain when walking Carl Ask your questions here 1 17th June 2008 02:35 AM
Bone quality and stress fractures Admin Podiatry Arena 0 13th June 2008 11:53 PM


All times are GMT +1. The time now is 05:12 AM.



Powered by vBulletin®, Copyright ©2000 - 2008, Jelsoft Enterprises Limited.
All content is copyright to the Foot Pain & Foot Health Forum.