EpicSki › The Barking Bear Forums › Ski Training and Pro Forums › Fitness, Health, Nutrition, Injury, and Recovery › My Excellent Toe Surgery Adventure - Hallux Rigidus, Plate/Screw Fusion, and Osteotomy
New Posts  All Forums:Forum Nav:

My Excellent Toe Surgery Adventure - Hallux Rigidus, Plate/Screw Fusion, and Osteotomy - Page 58

post #1711 of 1724
post #1712 of 1724

I am starting to look like a lurker.....

 

Kittygal

post #1713 of 1724

Crumpcake - I'm sorry to hear that your recovery is taking so long. You had a MTP fusion - right?

Yes, my cheilectomy sounds similar to yours regarding pain, but I lost almost all ROM. I'm still doing exercises for it over the past year, and got some rom back, but it's not much and it still hurts more than before the surgery.

 

So this surgery in April will be:

1 - a TMT fusion with bone shortening.

2 - I think it's called an osteotomy? (bone graft?) portion of the top of the metatarsal that will be fused, to the bottom of that bone on the MTP joint side( because mine we shaved off during the Cheilectomy).

3 - Cartiva in the MTP joint to simulate cartilage (I don't have any left).

 

2 Weeks non-weight bearing , Then 10 weeks in a boot. It's my right foot so no driving!

 

Look forward to all updates.

Thank you all for posting.

post #1714 of 1724
Quote:
Originally Posted by KrisClimber View Post
 

Thanks so much for your post Mom2Boys!!!

 

ToeCutter - Just the one bone graft - the first one you mentioned.

 


I uploaded an xray with the doctors ink of the changes.

The metatarsal head was shaved away by the cheilectomy on the outside.


Thanks for showing the x-ray. I'm still not sure where the graft would be going but I hope whatever you guys are trying works out for you. Good luck with it!

 

Just curious -- where do you live?

 

Edit: I think I understand what you were describing now. Your surgeon is suggesting to remove some bone from the TMT joint then graft it to the medial first metatarsal head, in essence giving you a bunion, yes? I wonder how he plans to fixate the graft to the metatarsal head AND insert the Cartiva implant? If one were to run a screw through the graft it seems as if it would hit the implant. The entire metatarsal head risks collapse so hopefully your surgeon is supremely skilled. I have to say, this plan is pretty unconventional. Please let us know if it works.


Edited by Toecutter - 3/19/17 at 10:31am
post #1715 of 1724
Hi Crumpcake, Thankyou for your kind welcome, and hello to all the others in the Toe club!
I am now 3 days post-op with my left toe fusion. My right toe was fused 7 years ago with two opposing screws, this time my left has been done with a plate and screws by a different surgeon, so interesting to see what is the same, and if anything is different!
Both times I awoke with the Velcro boot/sandal over bandaging, and both times I have been allowed to weight bear on my heel on the day of surgery. The first time there was a hard half cast over the big toe side of my foot, this time there is just bandaging.
So far things seem to be following a pretty similar course to last time - the day of surgery I felt surprisingly comfortable afterwards, and was able to hobble heelwise when necessary with little discomfort. However ... the following day the anaesthetic wore off, pain set in until the tablets took effect, and I took to crutches because any weight on my foot was painful! A few days on it's now a little better and I've been able to ease up a little on the painkillers, and am using the crutches and a little weight on my heel for balance when I need to mobilise (as little as possible!) At all other times it is elevated on a couple of cushions.
I read with interest the comments and issues some of you have had with cheilectomies. At my first visit with my current surgeon he gave me the option of a cheilectomy, but also commented that I would be back for a fusion before too long. His recommendation was to go straight to the fusion, since my other toe was already fused. I decided one operation was better than two, and having already had a successful fusion, I knew what to expect. Having read the comments, I think I made the right choice for me!
post #1716 of 1724
Nevada Sue - sorry to hear about your DIP joint problem. (I'm guessing that is the one on the big toe itself?). That's a bummer.

I am now at week 12 and doing good. Still using a crutch to take light pressure off foot when walking, and trying to walk mindful of using the whole foot. The foot still swells after 30 min standing frown.gif
post #1717 of 1724
Quote:
Originally Posted by Toecutter View Post


Thanks for showing the x-ray. I'm still not sure where the graft would be going but I hope whatever you guys are trying works out for you. Good luck with it!

Just curious -- where do you live?

Edit: I think I understand what you were describing now. Your surgeon is suggesting to remove some bone from the TMT joint then graft it to the medial first metatarsal head, in essence giving you a bunion, yes? I wonder how he plans to fixate the graft to the metatarsal head AND insert the Cartiva implant? If one were to run a screw through the graft it seems as if it would hit the implant. The entire metatarsal head risks collapse so hopefully your surgeon is supremely skilled. I have to say, this plan is pretty unconventional. Please let us know if it works.

It's the #2 part that's confusing. He's fusing the tmt. That's the tic tac toe board on the right. Then he's doing the Cartiva for the mtp.

#2 looks like he's grafting a bump on the medial side of the met near the head? That's what has me confused.
post #1718 of 1724

Hello all! I've been reading this long thread for a few weeks now :) and am so happy that I found it! 

I had the 1st MTP joint on my right foot fused four days ago, fixated with two crossed screws. I have a plaster splint over the toe and am allowed to walk on my heel in a postoperative shoe with the help of crutches. 

 

My background story is that I had a very successful bunionectomy on my left foot in 2008, then went in to have one on my right foot in January 2016. Instead of putting a screw in the bone, as was done in my first surgery, this surgeon put a pin through the joint and bone which was removed after 5,5 weeks - it was supposed to stay in there for 6 but I had intense pain from the pin after five weeks so it was removed early. 

I waited for my foot to heal and stop hurting, but after a few months I realized that something was wrong as it was getting worse, not better. I was referred to an orthopedic specialist who performed a series of examinations including MRI and scintigraphy, and eventually he came to the conclusion that I had osteonecrosis in the joint. Basically a part of the metatarsal head had died and ceased to exist, leaving a cyst which caused pain each time I bent the toe. Standing was no problem, but walking was painful and running was out of the question. In 2014 I ran two marathons... 

I'm only 37 and the idea of living with constant pain and not being able to walk more than 3 km a day for the rest of my life was unappealing to say the least. I don't care about high heels, I just want to live a normal, active life. Fusion it is. 

 

Fast forward to last week. He performed the fusion operation last Thursday, and told me that the bone looked perfectly fine now except for that missing part, and that everything went well. He was pleased to have been able to use two screws instead of a plate, as he said that plates often need to be removed after a while. 

 

The first three days were very painful. I took strong pain meds and slept most of the time. Today I already feel better though; was able to stop taking the oxycodone which I believe is what made me so sleepy. 

 

Anyhow, thanks to this thread (and my excellent surgeon) I am feeling very hopeful about the future. I am dying to get out there and start running again... or even walking without pain! 

post #1719 of 1724
Quote:
Originally Posted by dbpaddler View Post


It's the #2 part that's confusing. He's fusing the tmt. That's the tic tac toe board on the right. Then he's doing the Cartiva for the mtp.

#2 looks like he's grafting a bump on the medial side of the met near the head? That's what has me confused.

 

I think he's saying that the first metatarsal head is a bit narrow for housing the Cartiva implant, so therefore he wants to graft bone onto the medial first metatarsal head to make it broader. Somehow at the same surgery he wants to install the Cartiva implant even though the graft isn't fused. It would be very unconventional. I'd just fuse the thing -- less likely to end up with a giant mess where the metatarsal head disintegrates. There's probably more to the case than we're privy to.


Edited by Toecutter - 3/20/17 at 4:38pm
post #1720 of 1724
Quote:
Originally Posted by Toecutter View Post

I think he's saying that the first metatarsal head is a bit narrow for housing the Cartiva implant, so therefore he wants to graft bone onto the medial first metatarsal head to make it broader. Somehow at the same surgery he wants to install the Cartiva implant even though the graft isn't fused. It would be very unconventional. I'd just fuse the thing -- less likely to end up with a giant mess where the metatarsal head disintegrates. 

I'd definitely be deferring to the doc on that one. Maintaining the cortical rim is kind of key. I guess if there is enough of it and the graft is well fixed. That's why I'm on the outside looking in. smile.gif
post #1721 of 1724
Quote:
Originally Posted by dbpaddler View Post


I'd definitely be deferring to the doc on that one. Maintaining the cortical rim is kind of key. I guess if there is enough of it and the graft is well fixed. That's why I'm on the outside looking in. smile.gif


I wonder what the lateral view looks like?

post #1722 of 1724
Quote:
Originally Posted by Toecutter View Post

I wonder what the lateral view looks like?
Maybe he didn't have access to that view.
post #1723 of 1724

Kittygal, I was thinking about you the other day, wondering about the latest revision.  Glad it's good!

 

How did you find the surgeon who did your revisions?  I've tried googling, but am not coming up with anything.  There are only two orthopedic groups in my area, and each has one foot surgeon.  There are a couple of podiatrists, but I've not heard good things about them.  I'm at the end of my rope with the pain in my foot.  I can't sleep at night if I've been on my feet all day, especially if I'm up and down.  Did yard work yesterday and it still hurts like hell this morning. 

 

With all this political crap going on I'm afraid I will lose my insurance next year, so I'm feeling pressure to do SOMETHING.

 

Nevada Sue

post #1724 of 1724

Hi @NevadaSue and everyone!

 

I would recommend word of mouth to find a good revisionist. The professionals who will see the results of surgeries are the physical and occupational therapists, and the orthotists who make your orthotics. Those are probably the people most likely to have some input as to what they see, and how people are doing. But that is very tricky, as they don't like to say bad things about doctors. I think because I work in the medical field I am better able to gain access to the Inner Circle.

 

Bob and some others have lots of good things to say about the Steadman Clinic in Colorado. And I have read some literature written by Dr. William Fishco in Arizona who reportedly does revisions, but I don't really know anything about him.

 

The surgeon who did my thankfully very successful revision surgery was Dr. Jordan Grossman in Akron, Ohio, working out of Akron General/Cleveland Clinic. Not only a talented surgeon but one who listens.

 

Kitty

New Posts  All Forums:Forum Nav:
EpicSki › The Barking Bear Forums › Ski Training and Pro Forums › Fitness, Health, Nutrition, Injury, and Recovery › My Excellent Toe Surgery Adventure - Hallux Rigidus, Plate/Screw Fusion, and Osteotomy