Hello all, I am so thankful that I found a site with questions and answers for people with feet problems. I have had years and years of surgery on my feet due to a severe bunion and it deformed all my toes. I am seeing a new dr and I am scheduled to have fusion surgery on all of my toes August 3rd. I was just wondering what fusion surgery is? I don't see my dr for a couple of weeks to discuss this but I told people what is going to be done and they were telling me that fusion was where they take a piece of bone from your hip and sort of "weld" it into the joints of the toes. Is this true? I read in here where pins are inserted.
Help me please! I am confused! The time length for healing and do I have to wear a plaster cast are my other questions. I would appreciate any info.
Thanks a bunch
Darlene

I was wondering if I was posting this correctly. I see where Dr's answer peoples questions and I haven't seen any replies. Sorry, new to this.

Hi ! I was going to answer your post last night, but didn't have time to write a reply.. I was so excitted to FINALLY see someone else with a similar problem to mine!! My problem was severe arthritis in the Right Great Toe (the big one). A year ago, May 6th, I had surgery to remove the bone spur on the top of the toe, but it didn't realieve the pain, so this past March 21st I had the toe fused. When I had the surgery I knew it would be a 2 1/2 to 3 month recovery - at lest 6 weeks in a cast and on crutches.The first 2 days even with the Percocet where extremely painful!! I wouldn't lie about that . It has now been 3 1/2 months and it is still painful to walk. Next Thurs I see the dr again where he will take x-rays.. On the phone he said that he may try a bone stimulator. I can walk a little better, but it wstill hurts quite a bit to work. A few weeks ago I returned to wearing the Air Cast when i walk any distance as it keeps the foot a mroe stable then the post op shoe which I used after i saw him last on June 1st. If the pain goes away, I will be so happy to be able to walk again, but I am crossing my fingers it will happen!!
What has your dr told you would happen? Please post again here and let me know how it goes, OK?

Andrea

Andrea,
Thanks for replying to my post. I don't know exactly much of anything other then the surgery date is August 3rd. I have the worlds worst feet. I have had a total of 9 surgerys on my feet to correct a bunionectomy. All my toes on my one foot just went in all directions and the screw in the big toe is coming out. Looks kinda funny with the head of a screw pushing out on the top of my foot! If my skin on the top of my foot were any looser, I would be able to screw it back in myself! haha.
I do know that he said that he is going to fuse my toes. And the nurse that talked to me said that it will be about a 4 hours surgery. I tried reading on here what fusion was and it seems to be different kinds. From putting in pins to connect the bones to putting pins in and grafting bone from a hip. So I dont know what to expect! I wont see him again for a couple of weeks for a run down of exactly what he is going to do . I didn't know if a cast was something that is done all the time or not. From everything I have read that seems to be the result. I know that the first dr that did all the operations before said that the last step would be grafting and that was a longer healing time. And I work as an auditor in a facility that is 5 blocks long and wide and 3 floors high. So I do an extreme amount of walking for my job and my feet are ready to fall off at the end of a sometimes 12 hour day! So getting all my toes done at once makes me wonder just how long this healing time is before I go back to work. Most of my surgeries were only 1 1/2 hours and this is 4. Sounds more involved this time. Just lots of questions to linger in my mind for a couple of weeks........
Thanks for answering me, it's nice to know some one else that is dealing with this same problem!

I forgot to add one thing.. I also have a ganglion on the top of the foot where it bends at the ankle...... not that I need anything more wrong to add to the other problems with it!!!!!!

Darlene.
I hope that it helps to know someone else has gone through similar surgery (at least on the big toe). What you're having done sounds much more involved with the dr doing all the toes at once. I would assume that you will be in a cast non weight bearing for about 6 weeks. I went back to work after 2 weeks, but being on crutches was very difficult. I used the para transit here to get to and from work, but I still had to tdo the stairs in my buildiong. It was scary!! I also had problems with balance on the crutches so I was glad when I copuld put my foot down - litereally!! If you have that much walking at work, you may want to consider taking the time you'll be non weight bearing of rent one of those scotters to get around. I use them at the supermarket even thought I don't have a license - watch out!!
You said the screw in the big toe is coming out -ew!! My dr said they wouldn't have to come out. I have 2 in the big toe. I am lucky to live in Boston where we have a lot of Harvard Medical School Affiliated Hospitals. I had the first surgery at one hospital, but the dr didn't like answering my questions so I found another dr. As I said in the other post, I see him this Thurs, Juy 7th. I try to amke a list fo the questions ahead of time and I encourge you to do that as well. IF you can have another person with you at the appointment that would be great so you have another set of ears to hear what the dr tells you.
Do you have Yahoo messenger? If you do we could talk on there too. I hope to hear from you again.

Andrea

Andrea,
Your a hoot! No lisence and driving a scooter! I don't have yahoo messenger, but I do have email. It's DarleneT62@earthlink.net. Give a shout there if you would like.

Gonna be a long month of waiting for me. I'm going to have my nails chewed off by the time I see the dr and find out exactly what he is going to do. So thank you for being here for me! Hope to hear from you lots!
Darlene

Dear Darlene
A "fusion" is a surgical procedure that involves preventing motion in a joint. During the surgical procedure, a bone graft may be necessary either from the patient themselves or a bone bank. In order to stabilize the "fusion" site a pin, screw, or staple may be used depending on surgeon/patient.

Good-luck and thank-you for contacting foot.com,
SBarlizo, DPM, C Ped
foot,com expert

Hi Sblazio,
I wanted to let you know what the dr said today at my appointment. He took x-rays and 2 hrs after my appointment time he fianlly saw me! He looked at the x-rays and said that it was fusing and asked me to descbibe where it hurt not what makes it hurts which was hard for me to describe. The dr used his fingers to touch different spots and when he he got to the top of the big base toe, he hit the spot. I had spoken with the dr a few weeks ago and he said depending on the x-rays he'd prescribe a bone stimulator which I would use 30 minutes before bed. I asked him how long and he said until you don't need it. He said a rep from the company would call me in a week or 2 and come out to my house. This has to go through my insurance for approval, but the dr said he can write it in a way they will cover it.
I asked him again about taking Advil as he had told me after surgery, that studies have shown that Advil can delay fusion. I've been taking Tylenol twice a day and I don't think it has helped. Have you heard about Tylenol delaying fusion?I may try Advil for a day or 2 and see if it helps at all.
I have been corresponding with Darlene who has posted in this forum and we have exchanged information which I hope will help her. I know what it is like to anticipate surgery and the unknown afterwards. It's nice to have someone who has gone through similar toe pain as most people who post ahve had very different foot problems.
Please answer thjis post asap.

Thank-you.

Andrea

BIG OOPS! Spelled your name incorrectly. SORRY!!

Dr. SBarlizo,
I just wanted to let you know what the dr did in surgery. He performed alot and took 4 hours. He took a wedge out of the great toe and used an external pin and pinned it. The next 2 toes he fused using a pin with threads on one end drilled straight down through the top of the toes. the next toe he straightened and used an external pin. Then he removed a screw from a previous surgery and then removed a ganglion from the top of my foot. It will be a week tomorrow since the surgery and its looking great! Pain is going away a little more each day. Can't wait for the chance to walk for a while with out the pain!! Thank you for your support and answering my questions during my waiting period.
Darlene T

Dear Darlene
Good to hear that you are doing well. Make sure that you take it easy, pamper yourself during your recovery period.

Thanks for contacting foot.com,
SBarlizo, DPM, C Ped

THIS POST IS FOR DARLENE AND SBARLIZO

Hey Darlene,
Even thought we talk through im's and e-mails I still check thsi forum. Come on tonight and say "HI" . See what SBlazio wrote - take it easy and pamper yourself. That means keep your foot UP unless you are going to the bathroom!!
SBlazio,
I wrote a message weeks ago on this forum and I have yet to see a reply. It has been 5 months since surgey and it still hurts a LOT when I walk. I went to the dr last Wed and he said it was healing, but didn't know why it still hurts. That is NOT the answer I wanted to ehar from him that he didn't know why it still hurt. The x-rays he took this time were msotly weight bearing. I asked him to take x-rays of the other foot and I m beginning to get the same arthritis and bone spur in the left big toe. Hopefully it will take a long time to get to the point this one was at before surgery!!
Last Monday (a week ago yesterday) I got the bone stimulator. The company I got it from said I should use it the same time every day. I understand about being set for 30 minutes every 12 hrs, but why is it so important to use it at the same tiem every day? I was told it takes 3-5 months to see results since it takes that long why is it so important to maintain the same time each day?
The dr also gave me a shoe that has a wedge in the back. He said it will take the weight off the front of my foot. It isn't easy to walk in and going down stairs is slow so I don't pitch forward. Do you know if I am suppose to put any weight on the front of the shoe when I walk. When i do it hurts less than the other post op shoe but still hurts.
Please answer ASAP!!

Andrea

Dr, One more quick question, what would you say would be the recovery time before I can go back to work with all that was done to my foot? I am a quality auditor at my company and my job consists of walking up to 12 hrs a day sometimes 7 days a week. Just a round about figure would be nice.
Thanks again,,, and I am pampering to the best of my ability!

hi, i had bone fusion done to the top part of my right foot where it bends, i don't really have an ancle on either side of my foot anymore. i have degenrative bone disease, and i had 2 surgerys the first was with pins to fuse the bones, but when the doctor took out the pins it didn't hold, needless to say I was in so much pain every day. I am a press operator, i work 12 hours a day on concrete with steel toe boots on my feet. and i'm flat footed, so i had another fusion surgery, this time i had 3 long screws put in my bones to hold them in place. the surgery took over 6 hours. this was 3 years ago, it took about a year for my foot to really feel better, but even now i have my good days and my bad days, so i'm still in pain but not nearly as bad. but now the other foot hurts so bad, So i know i have to go to see my foot docktor to see what's up with this foot, it hurts worse than the bad foot even as we speek. at the end of the day i litterly can't hardly walk it hurts so bad. but good luck and hang in there, it'll get better.

Wow that sounds painful nhcyoume. I hope you are doing ok. 2 of my pins are external and 2 are in permenantly just because they have been operated on several times before and kept deforming. This I was told will keep them straight permenantly. Keeping my fingers crossed. I know where your coming from with the cement floors and 12 hours on your feet on them. We have 10 presses were we work and our facility is HUGE! Walking it all day long really exhausts you and especially if you have bad feet! Good luck and keep me informed on how your other foot is doing.
Darlene

so you work with press machines? I'm a press Operator. i ran a 6 color Stacy Kidder press and a 7 color Olympia press now i just moved to maryland and i run a small 1 color GTO press. not as hard work, thank God. yeah the external pins didn't hold my bones in place that's why i had to get screws. i have good and bad days, i just can't waite till winter up here. I came from the south and we were wearing shorts on Christmas. I heard it gets really cold up here. So i'll just have to see how my feet react with the weather lol

Dear Darlene
The question that you asked a while back regarding when you will return to work, really depends on how well you are progressing, that is, in terms of healing. Technically, bone heals between 4-6 weeks. However, there are a number of factors that do influence the healing process. Your surgeon would be the best to respond to this question because, he/she will also be taking sequential x-rays to track the bony healing process. You may also require rehabilitation....

Good-luck and thank-you for contacting foot.com,
SBarlizo, DPM, C Ped
foot.com

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Darlene.
I read your post about getting the fusion on your toes. I have a bunion near right big toe. Right toe leans slightly over toward second toe and my second and third toe leans toward the big toe and the second toe sometimes lifts up and over laps the big toe. My Dr wants to do a bunionectomy and straighten the second and third toe with a fusion in those two and pins he'll remove later too..
I asked him wouldn't a fusion limit my mobility? I don't want stiff un bending toes that just stick straight out or up. As it is now, yes, the bunion hurts if I wear a regular shoe , but not if I wear this extra wide pair of stretchy Euro shoes I have or flip flops or these sandals I have, that let the bunion stick out between the straps.

If I'm barefoot or in flip flops I have no pain at all. I'm reading some posts on other forums about with fusion you have these stiff toes that don't go anywhere. And they said you can never wear high heeled shoes ( not even even an open toed wide high heel with chunky, One and a 1/2 " and under, no higher, but not pointed spike heel?)
I don't want to be vain as I wear Euro shoes and flip flops 85 % of the time. But to hear you can NEVER again can wear even a nice comfy high heel shoe with fused toes?And it would be an open toe sandal kind of high hel I would wear not closed toed or pointed toed high heels.And no spike heel, but the chunky heel that is no higher then 1 1/2" high. And that only 1-2 times a week for a few hours a day. I can't even do that after fusion heels? I don't want to sound vain but my 65 year old friend had a bunion removed from the same Dr who wants to do my surgery and pins in her two toes to s traighten tem( but no fusion) and she' now dances and wears sexy high heels, even pointed toe boots, that even I wouldn't wear. I hate pointed toes.BUT, she didn't have a fusion either on her toes.
I read you can't do certain dances after a fusion ever again. Can't lift up on your toes to reach something. No high heel shoes of any kind, just flats and ortho pedic shoes. If hiking uphill you have to point your toes out as they won't
spring you up amnymore . That you can't do certain exercises and no squats at all every again. No rocking up on toes yet I read that flexing adn rocking on your toes is good for them. I read Arthritis could form in the joints next to the fused toes when I have no arthritis at all, due to them being tampered , cut and bone removed etc. And also due to not being able to flex them anymore, which is supposed to be good for toes and helpful for preventing Arthritis in the first place.. To flex and bend them and pick up objects with your toes. . And arthritis doesn't run in our family so I don't want to do anything to cause me to develope it.. Some people mentioned about on going pain for up to a year after and pain developing in the joints, that they didn't even have before the surgery. This is scaring me now and I'm supposed to have the surgery Friday Augus11th.
Are you happy you had the fusion? Are you finding your limited in many things you used to be able to do? Do your fused toes feel funny and stiff like robot toes? I hate to sound vain but I'm 48 and will be very unhappy if I come out with the bunion removed, toes straighter and better looking feet for sandals , only to have traded it for highly limited mobility and worse pain that stays permanently. Once the surgery is done, it's done, which is why I hesitate now.
So, can you please tell me how you feel about the fusion now? Was it worth it? Any problems cropping up?
Sorry to sound paranoid. But like a Dr once said on a talk show. You BETTER worry, it's your body and you have to live with the decisions you make for it. Plus hubby paying $ 6.200.00 out of his pocket due to no insurance. He worked hard for years to save that money and will be plenty upset if he sees me crying several months form now over pain, and wishing I hadn't had it done.
Thanks, Cheryl

Dear Cheryl
Your doctor has probably chosen to perform a fusion to the 1st metatarsalphalangeal joint due to the amount of arthritis and pain present at that joint. As the word fusion implies, it will result in no motion at the joint. It is not a good procedure for patients who may be a professional plummer, bowler, dancer, runner, etc....The procedure does not allow motion at the joint so it would be difficult to perform certain pedal functions. A heeled shoe can still be worn however, your doctor should be informed so that he can fuse the joint at an angle that will allow you to wear a low heeled shoe. If you are unsure about the procedure, it doesn't hurt to get a second opinion.

Good-luck and thank-you for contacting foot.com,
SBarlizo, DPM, C Ped
foot.com expert

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Thanks for the reply.
This is what I don't understand. My Dr. never said I had arthritis in any of my toes and none of my toes, not my big toe nor my over lapping toes hurt . If he said he saw arthritis in them, I sure don't remember hearing it. The only thing that hurts is my bunion on the right foot by my big toe. And that is only if I wear a tight shoe that's rubbing against it. As I am now, I can walk 2 miles a day in my wide Euro shoes with no pain, on the bunion. IF I wear that wide stretchy Euro sport shoe. Or go barefoot, flip flops etc. I can dance for an hour at a time ( barefoot). Jump, hop, run, stand on my toes and make ballerina moves during exercizing and even do some martial arts moves.
Pedal on my bike. I even jump rope.
There is no pain in my big toe, nor second and third toes that over lap. Once in a while they feel a tiny bit stiff, but it doesn't last and it doesn't really hurt.
I specifically told my Podiatrist TWICE, who is going to do the surgery, that I need to lose 30 pounds. That I used to be very slender and active, but severe depression I went through a few years ago, caused me to stop being so active and pack on the weight. So, I told him that I plan to be very active in the near future especially with walking and hiking. I already started to walk 1-2 miles a day, swim an hour a day and dance. I also plan to try learning some martial arts and hiking, as I'll be buying some mountain property. I didn't tell him all that about martial arts and wanting to get the mountian property, but I DID tell him at two different appointments that I was going to get big time into hiking and walking and bicyling and didn't want that impeded very much at all, if possible. He smiled when I said it so I know he heard me. I'm 48 but I've been told told I pass for in my 30's and would like to get in better shape again for my health.
Basically the bunion removal would be so I can wear different shoes and not have it rubbing on them. And the overlapping toe correction would be fixed along with it for basically cosmetic reasons for now, as they
are unsightly in sandals. But they don't hurt, even with shoes on. Although I'm sure it's not good for them to be leaning over in another toes space and one wanting to cross over the big toe. It's inherited from my dads side of the family. As several of them have the same condition. I don't think it is arthritis related for me at least. At least not yet.
My condition developed around 2004 on the right foot.They looked normal before that.

I cancelled my surgery for now and told my DR I would like to get a second opinion, as he and I disagree on the fusion procedure. I repeated to him again on the phone yesterday when I called, to tell him I was cancelling the surgery until I look into the different options for treatment. I said that I plan to be active and don't think fusion will allow me to be as active as I want to be, from what I am learning about it . He said he felt I was making a big to do about nothing and that fusion was merely going to prevent the overlapping toes from re-overlapping at a later date and it was not going to affect my mobility that much.
So, I will definately get a second opinion on the different options before I decide on surgery.
Thanks again for your helpful information.
dawn

Darlene

I really have empathy with what you are going through because I am in the same boat. 2 years ago I had extensive surgery on one of my feet - bunionectomy, removal of arthritic joints on the second toe and correction of 2 hammertoes. As luck would have it, when the bunion was removed and the bone broken to straighten the big toe the Dr. experienced trouble getting the screw in the broken bone - the bone splintered.
He finally had to do a graft with some special bone glue and put a plate in that had 6 screws plus a wire to hold it in place. Well, the plate is now loose and the screws are working their way out, and the graft appears to have broken down - I have no union of bone between the big toe and my metarsal and I cannot bend the big toe. Now I am told that the current plate needs to come out since the screws are loose, and I should have a bone graft using a piece of bone from my pelvis to hold the big toe in alignment with the metarsel. It would also require a "stouter" titanium plate with screws to hold the bone graft in place. This plate is to be permanent. The dr is predicting 8-12 weeks in a hard cast, 4+ weeks in an orthopedic boot and recovery to take about 1 year. I really don't want to think about it, and cannot decide what to do. I was hoping he could just take out the current plate and that would be it, however, evidently I would have a lot of pain and additional surgery would be needed. I am undecided what to do.

Lois

Dear Lois
I understand your apprehension. Maybe you should get a second or third opinion until you feel more comfortable with the next surgical procedure or treatment option.

Good-luck and thank-you for contacting foot.com,
Sbarlizo, DPM, C Ped
foot.com expert