Weil's Osteotomy of 2nd Metatarsal

Thank you for the reply. I also had a tendon cut and stretched and threaded through the bone to anchor the 2nd toe because I had torn the ligament holding it in place. I'm doing much better but still have swelling and nerve sensations that are annoying. Pain is much better and I'm walking better. Am just ready to be normal and be able to wear flats again instead of only tennis shoes. So at 5 months post-op for you - how close to normal are you? Swelling? Nerve sensations? Pain from walking?

Hi phoebekins. well I'd say my foot swelling is more or less completely down...( my foot was so swollen for the first few weeks after I got the bandage off I was quite shocked)  now though it's back to my normal shape foot... unless both my ankles are swollen because I've been on my feet too long then I'd say my operated foot is a bit more puffy than the other one which I think is to be expected.  I could not get normal shoes on for ages, but now can get some on, I've worn ankle wedge boots but the heel is not high, I'm a bit too wary yet to venture over 1.5 / 2 inch heels. I've tried to walk on my tip toes and I can do it carefully on my operated foot but I do it gently as obviously all the weight is going on the ball of your foot .  My toe where the tendon was cut is still a quite a bit swollen though, compared to the other toes, and whilst I can move it ok I do not have the same movement completely in it as I did before but I think that happens when the tendon is cut. I can live with this if I don't have the ball of foot pain as it was this that I could not cope with.  

Ive not much pain while walking now, I overdid it way too much before Christmas and my foot was throbbing and I worried I'd damaged my foot but I think it was just being on my feet too much after the op.  They say you take six weeks to recover, but I'd say it's only now the last month or so my foot has looked normal.  Another thing is I used to have very hard skin/callous  on the ball of my foot under the second toe, I don't have this now, the consultant said this was because the pressure on the second metatarsal is now a lot less.  Having said all that I have not been out walking on a higher heel for  hours or shopped with higher heels or boots so maybe time will tell whether that has improved too.  Before my operation when this all started about 6 years ago I had to stop wearing heels so much as the pain was unbearable , I tried  everything insoles,, reflexology, yoga toe stretchers, foot soaks, metatarsal pads and began to wear flatter shoes but by last year even flat shoes and even my trainers began to give me pain, so they agreed to this operation.

I did read that it takes 7 months to a year for the foot to be completely healed, though I'd imagine everyone is different   I think I've seen more improvement in the past month or two than the first few, and I think  that's since the swelling has came down a lot.  I sometimes soak my feet in Epsom salts and that seems to help.  

i don't have much nerve pain now I did get that before around the scar site but that seems to have gone too.  At the moment I think it's been a success

Hi, Lizbet - glad to know your swelling is almost completely resolved. You're a couple of months ahead of me, and the swelling is the main thing driving me crazy still. I will try the Epsom salts. I really appreciate all the info you shared with me. It helps to hear progress from a real patient rather than just my doctor's estimates if when I should reach certain stages. And, of course, he is not nearly as concerned as I am if I have to wear tennis shoes to a very nice event because that's all I can get on! Hope you continue on the road to 100% recovery. Many thanks for the help.

Hi Phoebekins ... your very welcome, it's very frustrating when you don't see much improvement or are not sure what stage you should be at.  My consultant said recovery will be about 6 weeks, I thought I'd be back in heels and dancing by Christmas ...well haha 😀That didn't happen.  He obviously meant you can walk about more easy at 6 weeks, but that's about it.  I understand what your saying about footware I've so wanted to wear my heels but I'm very wary, ive lived in trainers and fit flops this past 5/6 months ( though the first month I had to wear old trainers that were a size bigger as I could not get anything else on due to swelling. I'm hoping soon I can try out a heel even now and again . 

Yes do try the Epsom salts I bought a big 5kg bag online, dissolve a good cup full in hot water and soak your feet for 20/30 mins, it def helps with the swelling I think.  I also bought an ice pack online like an ice pouch with a lid you fill it with ice and that helped the swelling too.

i also took a photo of my foot every month or so, just to see if I could see an improvement, as it's annoying if you think things are not getting better.  I've enclosed a pic of my foot the pic on the left is just after I got my stiches out in middle of October last year and the one on the right was taken in the middle of February this year.... there's a good difference, though it's still a bit more swollen than my other foot but then my other foot has not been operated on .

Best of luck to you for a speedy recovery and nice footwear soon 

Lizbet x 

Hi, Lizbet - you have come a long way in terms of swelling since your surgery!  I have, too - I just thought I'd be totally back to normal after 3 months.  The nerve sensations are really driving me crazy lately.  I did try the Epsom salts one evening, and my swelling looked pretty good the next morning.  I just haven't made the time to do it again.  I feel like my whole life has been revolving around my foot!  Especially with physical therapy 3 times a week.  Am happy that I'm finishing it up this week.  Will just need periodic "tune-ups" to be sure everything continues to move correctly.  Are you worried that you'll need this surgery on your other foot?  Sometimes my left foot hurts under that 2nd metatarsal head, too - but the thought of going through this again leaves me reeling.  Ugh!!!  

Hi Phoebekins, well yes that has crossed my mind, though at the moment the other foot seems ok.  I have to say I'm going to be a bit more careful about what I wear on my feet, and hope to prevent this happening to my other foot.  Though my consultant said it was the way my foot was shaped or something and that the heads of the metatarsal bones pointing down more and were more prominent and therefor this was why I got the horrendous ball of foot pain.  Don't know if that makes sense 😀  but yes it was a far bigger deal than I thought when then said they would operate, I thought I'd have a wee plaster/band aid  on for a few weeks the. I'd be sorted haha... I came out of theatre with a massive bandage around my entire foot and it took ages to feel better .

My main issue now is my toe that they lengthened the tendon in, it tends to still look swollen a bit and does not always touch the ground like the rest of my toes.  I've read about floating toes after tendon lengthening and it's not as bad as that but I'm currently binding that toe next to my other toe to make it lie flatter in the hope that if I do this every day it will resolve. 

You certainly don't appreciate your feet until you have problems with them I think haha.

That's for sure, Lizbet!  I will never take my feet for granted again!  And my doctor had me wear a toe splint for a few weeks to keep that second toe down.  It's just a black fabric thing where one piece wraps around your foot and the other around your toe with a strip behind it that velcroes to the band on the foot and anchors the toe down in place.  You could probably get one on-line.  

lizbet x

Hi Lizbet!  I am scheduled to have this surgery the first week of October. I'm wondering how you both are doing now?  How is the swelling, the pain?  Are you able to wear heels?  What about activity level?  It has been so helpful to read about your journey. I'm terrified about doing this, but I've been battling this pain for three years - orthotics, padding, stretches, injections, nsaids, increasingly more orthopedic shoes, you name it!

I hope you have had success, and look forward to hearing from you!  

Cathy

Thanks!!

Hi, Texcat - My surgery was December 1st, so it's been 9 months.  I still have a tiny bit of swelling, which I only notice because some shoes I used to wear are a bit tighter over the top of my foot.  I followed all doctor instructions, especially to keep my foot elevated and iced post-surgery and to minimize activity.  I also faithfully completed physical therapy and all home exercises.  I can walk for miles, I can jog - I can do any activity.  I do have some stiffness, and sometimes some soreness if I've done a lot.  But most of the nerve sensations are gone, and I slowly am better and better.  I have worn a low heel, but I really only wear flats.  I have the same anatomy on my other foot and am not inclined to exacerbate it and have surgery again.  Best of luck to you!  It is no fun, but it is worth it to walk pain-free again.

Oh, I'm so glad that it has worked so well for you!  Thank you so much for posting your progress. I figured no news was good news.  it's been a very difficult decision to make for me, and hearing a success story make sure it a little easier.  Best of luck to you for continued healing and a pain-free foot - on both sides!  

Hi all I'm new to this too. Reading your posts has been really helpful, thank you, particularly this one from phoebekins. I'm scheduled for surgery at the end of Feb 2018, very nervous!My metatarsal problems are fall-out from bunion surgery 45 yrs ago & the plan is to have osteotomies of toes 2,3 and 4 on the left foot. I know it's getting worse & restricts what I do, but I'm not in continual agony, only after walking a distance and with certain movements, and I can't do impact exercise like running/skipping. I'm due to retire (I'm 60) this May and plan to be a lot more active than in my current sedentary job, eg outdoor volunteering, more walking, gardening etc and I feel I should just get it over and done with. Hence I'm nervous, & don't want to shoot myself in the foot (haha) - am I mad to have the surgery? The good thing is I'll have the time to recover. I know it's my decision ultimately but any thoughts would be gratefully received, thank you!

My first thought is have you received a second opinion recommending osteotomies of 3 toes?  Sounds very drastic to me.  My next thought is can you wait until after retirement so that you can take the time you’ll need post-surgery to optimize recovery?  My surgery was performed a few months before I turned 61.  I was in excellent health and good physical condition, having been very active before my foot pain restricted my activities.  I did everything my doctor recommended following surgery, which was only possible because I was retired.  He told me to minimize activity to keep swelling down.  So I did.  I spent 6 weeks mostly in bed with my foot elevated and an ice machine running.  I had a knee scooter to get around the house but spent the majority of time in bed.  My foot was uncomfortable otherwise.  Every appointment I was told that I was doing as well as anyone could be at that particular point.  I am convinced it’s because I had the luxury of recuperating.  I can’t imagine how I would have done if I’d had to go back to work after a couple of weeks.  I had no choice but to have the surgery - I had to have a walking boot on to get around because the pain had become unbearable.  Sounds like you’re not quite to that point but are headed towards it.  I’ll be honest.  This surgery is absolutely no fun.  And the physical therapy you need following is even less so.  I have the same bad anatomy on my other foot and am doing everything I can to avoid having to go through it again.  But a year later I’m pain-free and not hindered by my foot from doing anything I want to do.  The time to recover and to complete physical therapy is absolutely essential to a good outcome.  Can you put surgery off until after retirement?

Hi phoebekins thank you so much for responding, I was also thinking having 3 done feels a bit drastic, especially after reading how you were before your surgery. I'm nowhere near that bad and am still fit and active despite the pain. Reading about all the support you had with your recovery (ice machine, knee scooter) I'm guessing you're not in the UK! None of that, or even post-op therapy, has been mentioned to me so I've decided to get a second opinion and at least delay surgery until next autumn. Thanks again, it's so good to know people like you are out there!

You are correct - I live in Texas.  I had to purchase the ice machine and the knee scooter - but both are indispensable in my opinion.  My doctor told me that people with ice machines recover faster because it helps keep swelling down.  And my friend who also had foot surgery but spent a lot of time on crutches tore something in her shoulder with them and then had to have shoulder surgery!  My insurance paid for most of physical therapy, but not all.  My doctor said that physical therapy is crucial to a good outcome, and he made me sign an agreement promising to go when he told me I was ready and to complete the necessary course.  He refuses to do this surgery on anyone who won't sign.  Yes, do get another opinion and delay the surgery until you have the time to recuperate properly.  I want your outcome to be as great as mine!  All the best to you.  

Hi tc65156,

I had the 2nd MTP osteotomy done on October 4th.  I also had a nerve decompression in the 2nd innermetatarsal space.  I asked for them to cut out the nerve in my 3rd metatarsal space at the same time, but they felt that it would compromise blood flow to my 3rd toe if they did that, stating that there was enough disruption to blood flow with the work being done on the 2nd MTP and the nerve decompression in the 2nd innerspace.  

All in all, I am happy with the surgery.  I spent one month in a boot, fully weight bearing from day one.  I spent one week on the couch with my foot up and then I was back to work, as I had just started a new job and didn't have the vacation time saved up.  I will say that that I noticed a huge difference during that first month when I would go days without propping my foot up above heart level to keep swelling down.  My foot definitely let me know when it was in need of elevation.  My doc only prescribed massaging the incision area to keep the scar tissue from causing contracture, bending my toes down with my hand to keep them stretched, and doing the towel and marble grabs with my toes.  He never prescribed PT for me.  It's been 3 months, and I have worn a low heel occasionally out to dinner and for New Year's.  I feel a little numbness in the area, from the nerve decompression, but no pain.  There is some stiffness of the 2nd toe when I try to bend it up.  

The best part is that my doc said I could get back to cycling once the boot came off (one month after surgery). I have slowly started back and have had no issues.  It's wonderful to exercise again.  

I iced my foot with bags of ice occasionally, but no regimented plan for that.  

Good luck and keep us posted on you decision and progress!

Thanks for that Texcat, it sounds like you've made a great recovery. Since reading yours and phoebekins' posts I've taken the decision to delay my surgery for a few months. The main problem I have is the sharp pebble sensation when walking and a variable degree of throbbing along toe 2. All of this is bearable for the time being & I decided I'm not ready to incapacitate myself just as I head into retirement. I'm now working with my creative osteopath to manage things, then I'll go back to my consultant after the summer and reassess (unless something drastic happens earlier than that). It's been so helpful reading what you've had to say, thank you both so much. I'll let you know what happens, meanwhile best wishes to all.