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7 Weeks after Toe Fusion Advice Please

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Old 11th February 2009, 09:25 PM
amandajewls amandajewls is offline
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Default 7 Weeks after Toe Fusion Advice Please

Hi All - Please note I'm not looking for the solution to my personal problem but simply want to know what others have found in their experiences after a big toe joint fusion. Or pick their knowledge of the time after the air cast has come off after such a surgery.

What is the normal foot healing process after a big toe fusion (the joint on the ball of the foot) once the air cast comes off? What is normal to expect from the fused joint, endurance, delicateness?

Should I be still very delicate with my foot and not walk too much on it?

My journey so far: Dec 4, 2008 big toe fusion on first joint on left foot. Recovery very standard and good. Air cast introduced Dec 21st and wore it religiously until Jan 12 when it was taken off as per regular schedule. Exrays show very good healing.

I have experienced a bit of pain in the top joint now and my pod doc (a very helpful and respectable doc!) said it is the tip of my toe settling down back to the ground - so he says the tendons in that top joint on my toe are stretching out again and should settle down by 2 months after the air cast has come off.

What has been your experience at this stage of the healing process?

Kind regards,

Amanda
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Old 11th February 2009, 10:38 PM
FootDoc FootDoc is offline
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Default Re: 7 Weeks after Toe Fusion Advice Please

I have questions for YOU:

1. Why did you have a great to fusion?

2. What was attempted prior to the fusion?

4. What method of internal fixation was employed?

5. In what position in the sagital plane (degree of dorsi-flexion, if any) was the joint fused?

6. As the toe should now have no range of motion, why is the toe settling down to the ground and what tendons are stretching out?

7. Why do you claim that you are not looking for solutions to your personal situation when one of the first things you subsequently ask is, "Should I be still very delicate with my foot and not walk too much on it?"
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Old 12th February 2009, 03:53 AM
amandajewls amandajewls is offline
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Default Re: 7 Weeks after Toe Fusion Advice Please

I tried to edit my post so it didn't ask that question but now I can't edit it.

1. it hurt previously and I couldn't walk on it anymore
2. nothing except orthopedic pads from chemist and pain killers
4 post inside the two bones, plate on top held by 4 screws
5. no degrees different from plane of other toes.
6. Only the joint at the ball of my foot (beginning) of toe was fused. I can still bend the very tip at the top joint. This is what is now hurting.
7. I only want to know what other people have experienced in weeks 9 plus after their operation as I have not found a lot of literature out there covering this period of recovery. As previously stated I tried to edit my message to reword it - removing that question about myself - but now I am unable to.

Question for YOU.

Where did question 3 go?

Cheers
Amanda

Last edited by amandajewls; 12th February 2009 at 03:55 AM.
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Old 12th February 2009, 02:00 PM
FootDoc FootDoc is offline
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Default Re: 7 Weeks after Toe Fusion Advice Please

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.
************************************************** *********
When I asked why you had the fusion, I had anticipated a diagnosis, not just that "it hurt." In lieu of your failure to specify a diagnosis, I will assume that you had hallux limitus due to osteoarthritis. If it were hallux rigidus, there would have been no need for a fusion, as, by definition, there would have been no motion possible to start with. By your use of the term "chemist," I assume that you live in the U.K., thus I have no idea what the standard of practice is there. But in the U.S., fusions of first metatarsal-great toe joints are only considered as a last resort, and certainly not simply because store-bought pads have failed . . not that pads would be effective for hallux limitus anyhow. So I really have to guess what this is all about, as I cannot imagine a fusion being performed as the initial professional treatment for hallux limitus. If I actually have the picture you paint correct, in my opinion and training, a fusion of the great toe joint, as you seem to describe, which is permanently positioned with zero amount of dorsiflexion is, in my view, unworkable, as one needs to at least have some fixed amount of dorsiflexion of the great toe in order to be able to walk in any manner even approaching a normal gait. It is no wonder that you are smashing the distal tip of your toe into the ground. If indeed the picture you have offered is as I have stated, I've never heard of doing any of this in any such manner, and I really cannot comment as to your prognosis. Say it ain't so, Amanda!
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Last edited by FootDoc; 12th February 2009 at 02:04 PM.
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Old 12th February 2009, 09:51 PM
amandajewls amandajewls is offline
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Default Re: 7 Weeks after Toe Fusion Advice Please

Diagnosis:
2008: Notes from X-ray: Comparison with previous report of 15/1/07 made. There is again moderate osteoarthritis of the 1st mpt joint with associated joint space narrowing and large marginal osteophytes. The alighment is maintained.
2008: L 1st MPT joint osteoarthritis by the Specialist Orthopaedic Surgeon and since 2007 I have consistently been told there is no solution. It was the orthpaedic surgeon who told me the options of the joint replacement or joint fusion. I chose joint fusion.

Operation: L 1st MTP joint fusion and bone graft, a plate and screws and a cannulated screw internally fix the 1st mtp joint in near anatomical alignment.

Does this clarify things abit?
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Old 12th February 2009, 10:15 PM
FootDoc FootDoc is offline
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Default Re: 7 Weeks after Toe Fusion Advice Please

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.
************************************************** ***********
In my experience, I find that a joint replacement or even a Keller procedure where the joint is removed and the toe allowed to "articulate" on the scar tissue is generally far preferable to a fusion, and if a fusion were performed, I would certainly not have fixed the great toe in a neutral position without any dorsiflectory attitude, which is what I infer is probably at the heart of your complaint. In its stead, I certainly think that you probably need a metatarsal rocker bar on your shoe.
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Old 10th March 2010, 12:47 AM
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Default Re: 7 Weeks after Toe Fusion Advice Please

Quote:
Originally Posted by amandajewls View Post
Hi All - Please note I'm not looking for the solution to my personal problem but simply want to know what others have found in their experiences after a big toe joint fusion. Or pick their knowledge of the time after the air cast has come off after such a surgery.

What is the normal foot healing process after a big toe fusion (the joint on the ball of the foot) once the air cast comes off? What is normal to expect from the fused joint, endurance, delicateness?

Should I be still very delicate with my foot and not walk too much on it?

My journey so far: Dec 4, 2008 big toe fusion on first joint on left foot. Recovery very standard and good. Air cast introduced Dec 21st and wore it religiously until Jan 12 when it was taken off as per regular schedule. Exrays show very good healing.

I have experienced a bit of pain in the top joint now and my pod doc (a very helpful and respectable doc!) said it is the tip of my toe settling down back to the ground - so he says the tendons in that top joint on my toe are stretching out again and should settle down by 2 months after the air cast has come off.

What has been your experience at this stage of the healing process?

Kind regards,

Amanda
Hi Amanda
I had the same thign you did. The healingprocess did go very well. I had two toes done and they are straight. There was only pain the first night. After that i could walk in the boot. After 9 weeks i was wearing sneakers. It just takes a little bit to walk again-from cast back to shoes. Now I have arthritis so i still have pain but not in those two toes! Jen
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Old 27th April 2010, 06:23 PM
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Unhappy Re: 7 Weeks after Toe Fusion Advice Please

I am getting ready to have toe fusion also. I had a toe implant 2 years ago and have been in pain for 2 years. i walk with a limp and cannot wear any shoes just ratty old worn-out sneakers because top of foot is so sensitive and bone near implant too. i am very frustrated. i am 54 and going in for surgery soon for toe fusion. i have to do it because can't live like this. quality of life is non-existent now. i pray that the toe fusion will help me.
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Old 27th April 2010, 09:16 PM
FootDoc FootDoc is offline
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Default Re: 7 Weeks after Toe Fusion Advice Please

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 assume that you are speaking of the great toe joint. If indeed the pain was caused by hallux limitus, a fusion has a good likelihood of resolving that pain, although fusing an important joint such as this is not without its side effects. But apparently you have not had what could be considered a functioning joint anyhow.
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Old 20th October 2011, 01:43 AM
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Angry Re: 7 Weeks after Toe Fusion Advice Please

Quote:
Originally Posted by FootDoc View Post
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.
************************************************** *********
When I asked why you had the fusion, I had anticipated a diagnosis, not just that "it hurt." In lieu of your failure to specify a diagnosis, I will assume that you had hallux limitus due to osteoarthritis. If it were hallux rigidus, there would have been no need for a fusion, as, by definition, there would have been no motion possible to start with. By your use of the term "chemist," I assume that you live in the U.K., thus I have no idea what the standard of practice is there. But in the U.S., fusions of first metatarsal-great toe joints are only considered as a last resort, and certainly not simply because store-bought pads have failed . . not that pads would be effective for hallux limitus anyhow. So I really have to guess what this is all about, as I cannot imagine a fusion being performed as the initial professional treatment for hallux limitus. If I actually have the picture you paint correct, in my opinion and training, a fusion of the great toe joint, as you seem to describe, which is permanently positioned with zero amount of dorsiflexion is, in my view, unworkable, as one needs to at least have some fixed amount of dorsiflexion of the great toe in order to be able to walk in any manner even approaching a normal gait. It is no wonder that you are smashing the distal tip of your toe into the ground. If indeed the picture you have offered is as I have stated, I've never heard of doing any of this in any such manner, and I really cannot comment as to your prognosis. Say it ain't so, Amanda!


hello foot doc can you please look at my post? mezinpain? thank you
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