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Fusion of main big toe joint

Discussion in 'Ask your questions here' started by Robster, Feb 8, 2019.

  1. Robster

    Robster New Member


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    Hi all,

    I have injury related arthritis of my left big toe, currently causing reduced movement and some pain. I’ve been told by 2 surgeons that I need to have the joint fused. I am 42, very fit and active, enjoy running, hiking and have a young family that I want to remain active for... reading forums and general online research is leaving me very concerned with the possible outcomes of the fusion surgery.

    For people that have had this procedure done, after the recovery period (which I know is a long time), what’s your experience post op? I imagine walking must be quite awkward if you can’t bend your toe (as it’s naturally designed to do to enable walking) - as it is, with the reduced movement in my toe I already walk on the outside of my foot with a slightly awkward gait. I know stiff soled shoes help with this a lot, but can you walk relatively normally in soft shoes/bare feet? Can you run? Do other sport?

    I’d be grateful for your experiences as I don’t know whether to put off this surgery until the pain is unbearable, or to take the surgeons’ advice and look forward to going back to being active and without discomfort again.

    Thanks,
    Rob
     
  2. Julie

    Julie Guest

    hi Rob

    I too am contemplating toe fusion. A steroid injection gave very little relief but I’m so scared about recovery and pain being transferred to somewhere else. I have very little bend already but bend it I can despite the pain. I’ve read mainly horror stories. I’ve had several ops over the years for bunions so I know the score but this is permanent - no turning back?
     
  3. Robster

    Robster New Member

    Hi Julie,

    I think the point is it’s very easy to find horror stories, hence reaching out on here to try to find some helpful information.
     
    Julie likes this.
  4. I had my right foot big toe 1st metatarsal joint fusion surgery Jan 22 2019. I am early 60's, and this surgery was necessary as there was no cartilege left in the joint, as well as bone spurs due to ostoarthritis (wear and tear of all those years of walking) . Pre surgery consults told me the recovery would involve at least 8 weeks befor I would be able to try shoes, and up to 12 to 16 weeks befor I can return to active activity. All of that is true, there is no way around it, it takes a long time to recover from this surgery. I do not expect to be back to fully functioning until June. The first 4 days after surgery I needed pain killers, and was basically bed bound, luckily I had lots of help from family. First 2 weeks, total non weight bearing (NWB) while wearing an air cast up to my knee 24/7. From 2 to 4 weeks, slight pressure on heal only while using crutches, or a rolling walker with my knee up on the seat, and still wearing air cast 24/7, but did take it off a couple of times a day while sitting to do some rolling ankle exercises. After 6 weeks I began rolling a little onto the ball of my foot while in the air cast using crutches for support, but still mostly NWB, and I took the air boot off to sleep. After 7 weeks I was able to basically 'walk' while in the aircast, although it was hard on my ankle. I am now 8 weeks, have moved out of the boot into a slide in mule croc shoe, 2 sizes bigger than my good foot. Swelling continues through the foot, the lesser toes and ankle, but no pain on the joint, mostly uncomfortable due to swelling. I still need to spend time sitting with my foot elevated. Walking carefully and slowly for short distances over level ground, or around the house, rolling on the ball of my foot and lesser toes. The fused toe is stiff as one would expect. I use walking poles to steady myself outside. Once the sugical wound is fully healed and dry I will be able to swim or use a staionary bicycle for exercise. I still can not drive a vehicle. Stairs are still a challenge, although I can no go up one foot after the other, and down placing the healing foot carefully without weight bearing one step at a time. I do not know how well the bones are fusing yet, I don't see the surgeon and ex ray until 12 weeks in. Until that time I will continue to walk carefully and rest when my foot tells me to. I feel small improvements daily. My biggest challenge is impatience.
     
  5. barb H

    barb H Guest

    Hi ,
    I also had my big toe joint fused and shaving of bunion on January 11, 2019. I’m 14 weeks post op and while the recovery is definitely slower than I expected, I feel that my foot is beginning to improve on a more consistent level. I was non weight bearing for 5 weeks because I had lost doris flexion of my ankle and needed PT to regain the flexion. I then was on a protocol of weight bearing as tolerated. I used a walker and wore a Cam boot during this 4 week period. I graduated to a cane after that and used the cane for an additional 3 weeks. I’ve been weight bearing for the last 2 weeks and have a very slight limp in the morning and at night when my foot is tired and swollen. I’m still going to PT 3 times weekly to decrease my big toe stiffness, decrease internal scar tissue around the site of the fusion and increase my ROM to my toe and ankle.
    I went for my first short hike today for 30 minutes. I hope to slowly increase my activity level on a daily basis. I’m still wearing a sneaker because I feel it protects and cushions my foot. I’m also walking barefoot around the house because my ortho wants me to be more aggressive and it will also help to smooth out the scar tissue on the arch of my foot.
    I have a scheduled bike trip on June 18th in Italy and I believe that if my foot continues to improve slowing but consistently, I should have no problem with cycling. But I reserved an electric bike, just to be on the safe side!
    Foot surgery is one of the slowest recovery areas of the body and so anyone contemplating a fusion, be patient!
     
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