Recovery after big toe fusion

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On 31st January I had big toe fusion performed on my left foot, together with Weil osteotomies on my second and third toes.  This was because I had a severe bunion (36 degrees) and a hammer toe, so the surgery was quite extensive, taking over three hours.

My right foot has already been corrected, but the problems were rather less serious and I 'only' needed a Scarf & Akin on the big toe and a Weil osteotomy on the hammer toe.  No fusion was involved. This was back in March 2016, and I recovered really quickly as these things go, so was able to drive at 4 weeks post-op and was more or less back to normal at 3/4 months.

My doctor has already warned me that recovery this time around will be slower.  What does this mean in practice? I would be grateful to hear from any one who has had experience of this procedure.  I am not in a cast, my foot is just bandaged and I can already walk in a Podalux shoe with a crutch - although at the moment I am, of course , icing and elevating almost all the time! And can any one tell me if, in their experience, the long-term result of fusion really so different from non-fusion.

Thank you!

 

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  • Posted

    I had pretty much the same done as you.... it was revised surgery after a double bunion operation wasn't done correctly in 2014

    In 2016 I had a plate and screws inserted in my big toe and pins in the 2/3rd toes due to hammer toes. Like you I wasn't put in a cast, just a thick dressing and was given a surgical

    shoe and crutches.

    For the first 2 weeks I was non weight baring, only allowed to go to the bathroom, minimal walking.

    At my 2 week check up I had my dressing removed and stitches out..... my foot was the covered with a tubagrip dressing.....still in the surgical shoe and minimal weight baring and not allowed to get the foot wet... any walking was strictly flat footed and no rolling from heel to toe.

    I was advised that once the scab had fallen off and I was confident that the wound had fully closed to massage the scar gently but firmly with oil to help prevent scar tissue forming as this can cause an eliment of pain.

    I had check ups at 6 and 12 weeks with x-rays taken at every check.

    At 12 weeks I was finally released from the surgeons care with the advise that it can take up to a year to fully recover as bones have been broken and nerves had been messed about with....

    Take time to let things recover and don't push yourself.

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    • Posted

      So far this doesn't sound so very different from my less serious hallux valgus recovery schedule.  When were you out of the surgical shoe and actually able walk with an ordinary shoe?  And when were you able to drive?  My doctor is saying probably 6 weeks post-op, by which time I think I will be going crazy!  So hoping that 4 weeks will be possible again this time - I think I can handle walking later better if I have the freedom of being able to drive places.

      All info much appreciated - thank you smile

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    • Posted

      I eventually felt comfortable enough to wear training shoes at 13 weeks post op.... I did try after the 6 week check up but the swelling made it uncomfortable to have my foot enclosed footwear.

      I didn't drive until about 14/15 weeks post op which was more down to the fact that if I'd walked for a while once I'd got to my destination my foot would swell and my leg had that blood rush feeling so I was concerned about driving homeward and more to do with breaking.... you should be able to do an emergency stop comfortably.

      I tend to walk most places so it didn't bother me....I do remember while out on a walk when I was about 10 months post op that my foot felt 'good'.

      After waiting since 2015 for the same operation on my left foot, bit of a long story, I've just been given a date of the 20th of this month to have the op.....fingers crossed it doesn't get cancelled again... I feel it been a long waiting game that has been on going for years so will be glad to finally put if all behind me.

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    • Posted

      Does all this date back to the failed operation in 2014?  That is  indeed a very long haul if your second foot is only being sorted out now, especially if it is causing you pain. You have all my sympathy!  It's been bad enough putting off the operation on my second foot for a couple of years, even though this was almost entirely of my own volition.  The stress of knowing that you have this type of surgery pending is not pleasant, to the point that it is quite a relief to bite the bullet and finally get on with it. Why was the op cancelled last time?  

      I have my first check-up tomorrow, 9 days post-op.  I'm hoping they take some xrays so I can be assured that everything is in the right place.  I find the idea of having a plate in my foot quite disturbing, not quite sure why it seems worse than pins and screws. I gather from what you have written that the operation on your right foot has been a success.  I find that very encouraging as I have read some negative opinions of fusion (which I am hoping are the exceptions rather than the rule).  

       

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    • Posted

      Yes, it all stems from the original operation.

      I'm in the UK and it was cancelled due insufficient funds.

      Managed to get to see a surgeon again who reinstated me back onto the list.

      Although today I've a message on my answer phone today asking me to call the hospital as unfortunately my operation date will have to be changed 😩

      I really hope it doesn't get cancelled again as I think you build yourself up and I feel that it's kind of been ruling my life. I just want the operation over and done with...

      I did call back but they'd gone home.....Will phone first thing tomorrow.

      I won't say that somedays the toe doesn't feel odd at times.....not painful but just that I sometimes think I can feel the plate, which as you say is odd in itself to think that we've got the 'object' in our toe.

      After my first operation I joined some Facebook groups to do with bunion/hallux surgery....they're a god send and so full of information.

      Do you not have any metalwork in your toe?

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    • Posted

      Have you managed to fix a new date?  I am not in the UK, and it does seem quite extraordinary to me that you are having such difficulty remedying the original operation that was performed on the NHS and is therefore their responsibility.  That both feet need remedial work says it all. You should be put at the top of the list! I do hope they can propose something in the very near future.

      My foot was re-bandaged this afternoon. Not a pretty sight, but that's to be expected at this point.  No X-rays today, that's for next Friday.  The best news was that I can now do a little walking everyday (with the surgical shoe, of course), so very much better than nothing but constant elevation and icing. Quite a relief.

       

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    • Posted

      Yes....The surgeons secretary phoned yesterday and rescheduled the operation for March 1st so not too long a wait.

      The waiting lists for operations on the NHS are long.....I've was actually removed from it last year.....then reinstated after my GP wrote to the surgeon.

      We are quite lucky having it but I suppose nowadays more people are using it and as there's only so much money going into the pot.

      Good too hear that all is going ok with you, can be a bit of a shocker seeing your foot at the first unvailing....

      I did take pics before the new dressing went on but the second dressing was one that I could fold up to reveal the foot which was nice as I could let the air get to it....

      Yes, it's also nice to be able to do a few extra steps after being NWB for the first fortnight.

      Elevation is still important....

      On one forum icing was suggested to be done by placing ice pack behind the knee but it annoyed me so I filled a zip lock bag with ice. I placed a folded towel on the bed which I put the bag onto to soak up drips and covered it with a thin cloth so that it wouldn't actually touch my foot. Then I'd put the sole of my foot on it and ice that way.....

      Good luck with your x-rays.....fingers crossed healing goes well.

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    • Posted

      Thank you very much, I am trying so hard to be patient but find it so difficult to be cooped up.  I am curious as to why your initial operation didn't work.  What went wrong?  Why was the fusion more successful? I must say it's really tough to have to go through it all again, the recovery period is so long and tedious....

      My brother-in-law is a consultant rheumolotogist with the NHS, so I hear a great deal

      about the problems from him.  I'm in Belgium, where quite a lot more is spent per capita on healthcare, but then we pay higher taxes too. But it does seem worth it when you need the service, and I'm really grateful that I only had to wait three weeks to have my op once I finally took the decision to go ahead.  Let's just hope March 1st doesn't move - then you should be over the worst in time for some decent weather!

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    • Posted

      It is hard to sit still if you're used to being active.

      I'd planned to catch up with reading all the magazines that I'd bought but never got the time to sit down and read .....hence for some reason the concentration to manage was never there....although all the magazines are to this day.....maybe more luck this time.

      I'm really not sure what went wrong, my right foot still had a bunion and the toes had all moved......left foot toes,have moved outward which causes pain on the ball of the foot....

      The fusion worked as the toe bones are now held in place with screws and pins.

      There used to be an option to post photos on here but that seems to have gone now.

      I received another letter this morning for my new op date, March 1st, so fingers crossed it'll all be over soon and the long recovery period can begin.

      I drive an automatic car so if that awful blood rush feeling doesn't last long, can't remember how long it was the last times, I can hopefully at least drive to our local garden centre for a change of scenery and a coffee..... but for the first 4 weeks or so it'll be mainky elevation....

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    • Posted

      I have read in various places that fusion can lead to stiffness of the big toe as a long term consequence.  To what extent have you found this to be the case? Some people say they can still wear 3" stilettos (not something I have done for a long while!) , while others talk as if they are permanently handicapped. Also, did you do much physiotherapy post-op and, if so, was it useful? I had 20 sessions after the operation on my right root, but that was non-fusion and I'm not convinced it helped much at all. It's difficult to prove a negative, however, although my impression was that time did most of the healing and that the physio just made it ache.

      X-rays are scheduled for tomorrow, and I must say I am quite apprehensive. I wonder how often these things go wrong.....

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    • Posted

      My toe feels numb when touched.....permanently stiff.... doesn't bend at all.

      Never bothers me. I wear training shoes mainly they just feel more comfortable, sometimes if feels as though my sock has bunched up under my fused toe but that's probably as the toe itself doesn't bend.

      I'm not a high heel wearer.....haven't been much of one even when younger...

      I didn't have physio after any of my operations, wasn't offered.

      I do keep saying that I'll go and have a foot massage as my foot does feel like it needs to be 'loosened'.

      Think it became a habit to not bend the ankle and roll from heel to toe...

      Good luck with the x-rays.....hope all is on the mend.

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  • Posted

    Actually I think the only useful thing the physiotherapist did was to massage my foot, that did help, albeit only temporarily.  It was nice while it lasted!  So that may well be worth pursuing for both your feet after the next op.

    I'm relieved to report that all appeared to be in the right place on the x-rays yesterday, although I seem to have enough metalwork in my foot to start an ironmongers.  Just hoping it all stays in situ. The stitches were removed, and some quite intricate strapping was applied - not sure if you can see from the photo.  The aim of all this is to ensure that that the second toe is held in the correct position while it heals. My surgeon does not use k-wires (which I gather is the standard procedure for hammer toes in the UK and US), instead he has done a tendon transfer which should keep that toe flexible subsequently.  Apparently this is the preferred method in Belgium and France.  It's certainly all very uncomfortable at present but I guess that's to be expected.  Thank goodness for Tradamol.

    I was also greatly heartened  to be told that I should be able to drive at 4 weeks post-op.  I am so very pleasedsmile.  Can't wait to get back behind the wheel. But to use the foot on the clutch I have to wear a completely stiff/rigid soled trainer.  I didn't have to do this with my other foot and my trainers have flexible soles.  I've had a look on-line, but the rigidity of the sole is not something which shoe retailers bother to indicate. Did you have this problem?  Any idea which brands do this sort of thing?   Most trainer manufacturers appear to pride themselves on how very non-rigid their shoes are, not the reverse.  I fear this could be difficult......

     

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    • Posted

      Glad to hear that all is mending as it should.... stage one out of the way..

      How did you post a picture.....I can't see the little icon they used to have?..

      I didn't have k wires either, my 2nd/3rd toes were pinned to correct the hammer toes. They're not dead straight but no longer have that scrunched up look.

      I didn't drive for a while after my operation, which was more down to having that blood rush/throbbing feeling. I was ok walking around the house at about 4/5 weeks post op as I could sit down when the throbbing started and elevate my foot...

      At around 6/7 weeks I'd go out as a passenger in the car but still didn't drive as my foot would still swell and ache after walking and I'd be concerned about breaking in an emergency.

      I was still wearing my stiff soled surgical shoe at 12 weeks.... It's the only thing that I felt comfortable wearing so when I was driving that was stiff enough to keep the toes straight. Then if needed I'd change into my training shoes...

      I'm going to have a good foot massage when all of this is well and trully behind me.....may have some reflexology as well..

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    • Posted

      In the reply box at the top right hand side there are four icons.  The icon on the furthest right (not sure what's it's supposed to represent: a circle over a hill?) is the one you click on to insert a photo. Strangely it then shows below the box, but that seems to sort itself out when the message is posted.

      My surgical shoe is so thick it would be impossible to drive in it, so I will have to find another solution. Right now I would not want to put an ordinary shoe on, but hopefully in a week or so the foot will be that much better and I can go off in search of some really stiff soled trainers althoughI have no idea where to start.  I don't wear trainers that much anyway, so I will have to rely on my Superga-toting daughter for leads!

      Not long until your op now.  Are you having exactly the same treatment as on your other foot?  That would have the advantage of knowing what to expect. At least you will know what to have organised for your convalescence at home beforehand.

       

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    • Posted

      Ah...... I don't have the little icons on my tab/phone for uploading photo's...

      I've known people to wear men's training shoes after having bunion surgery as the toe bed is wider than on a womans shoe.....I bought a pair of mens sandals after my first op to wear when I went on holiday...much more room.

      I've lived in training shoes. I did go to Hotter shoe shop and buy 2 pairs of leather shoes but one pair slipped on the heel of the left foot causing blisters, I'm sure it's smaller than my right now. So I gave up on them, will try again when I'm healed.1

      I think I'm having another fusion wouldn't be my first choice but the surgeon thinks it'll have the best out come ..... my feet do feel really stiff lately.....Both of them, I do walk alot though....

      I've spent time cooking meals to put in the freezer, it's important to rest up after the op and I know if there isn't any meals done I'll attempt to stand and do them.....plenty of other things that only need to be shoved in the oven....I'll organise the freezer so that everything is to hand.... the boys can pick up bread and milk along the way.....

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    • Posted

      Sorry, I haven't expressed myself clearly.  The icons are on the website - see the attached screenshot. You do have to open up a reply box to be able to see them.

      Yesterday I did my first supermarket trip since the operation.  I feel I have reached a milestone!  Admittedly it was in a wheelchair (it is a very large supermarket), but nonetheless it makes me feel that I am slowly getting back to normality.  The experience verged on the scary as my daughter had a few learner driver problems manipulating the combo, but we survived intact - chair plus atttached trolley is amazingly cumbersome.  It certainly makes you realise how very difficult life must be for people who are permanently wheelchair bound.  I hope tomorrow to get to a language class if I can persuade someone to transport me there and back.  I have been meaning to spend this time laid up learning vocabulary and irregular verbs, but somehow it just hasn't happened. Quite amazing how a foot op can affect the brain...

      I'm most impressed by your forward planning!  It's certainly true that the first couple of weeks it's non-stop bed rest, so you are very wise to think ahead, there are so many things you don't really realise you do until you can no longer do them.  My best investment this time has been a Nespresso coffee machine which I have installed by my bed, and a large supply of decaffeinated capsules.  Has helped enormously!

       

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    • Posted

      I still don't have the icons..... I've asked my techie son why I can't get them and they said it's the way the website is formated....

      Are you on a mobile devise?

      Shopping at the best of times can be a nightmare but as you say wheel chair bound when you're not used to it with someone else incharge of steering must be a sight to behold.... you are right though in not walking around the supermarket just yet, plenty of time for that, it's rather strange to have to rely on others when we're so used to just getting on with things inmour own time..

      I drink far too many latte's so it will be good to not be able to get to Waitrose...free when you buy something.... or to my own kitchen for a while.

      I'm going to try this time and get through some of these magazines that have piled up.... but I can only assume that having a general anesthetic causes brain freeze.

      Both of my feet hurt last night so I got a small soft ball and placed it in the arch of my foot and rolled it in circles, felt some relief this morning.

      Not long now until my op..... but I keep thinking that it'll be 2019 until I can, hopefully, put all of this behind me and I'm fully recovered.

      I'm very apprehensive of having metalwork in both feet as the resistance feeling in my right toe is still quite alien, even after all this time.

      Maybe a good foot massage once fully healed will help with the stiffness.

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    • Posted

      It does seem very strange that you cannot access the icons. I am using a standard Windows 10 Asus Zenbook (laptop) and the icons just pop up when  I open a reply box.  But I know absolutely nothing about computing so can say no more than that.  It's a pity that there doesn't seem to be a Help link to assist with such matters.

       

      I made it to the language class today but have to admit that three hours of Dutch was probably not a

      good idea for my foot, even with it elevated.  It's one thing to be propped up in a nice comfortable bed or sofa, quite another to be perched on a hard plastic chair. Not sure my head was really up for it either!  Nonetheless, I'm glad I did it even though I'm not sure I learnt much - I don't think I can have done the foot any harm as I had no weight on it, it was just really uncomfortable.  Hopefully it will be that much better by next week.

      Are you going in as a day patient or are you expecting to stay overnight?  Do you have a preference? I wasn't given the option, perhaps because of the extent of the surgery, but it does seem that quite a few people are in and out the same day for bunion ops.  Will you see surgeon between then and now, or do you just show up on the day?  Have you had a nerve block during your previous operations?  A real godsend, in my view, it really helped with the pain control post-op.

       

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    • Posted

      I'm in no way good with technology either.... must drive my son mad at times....

      3 hours of learning a different language at the best of times must be difficult but with your foot resting on a plastic chair you did well. I'd have spent most of the time fidgeting.

      I'm expect to only be a day patient, stayed overnight last time....not sure why.

      I've to be at the hospital for 11.30am.... so it'll be an afternoon op.....then home early evening.

      I won't see the surgeon now until the day..... dare say he'll come and draw some kind of mark on my foot just to make sure it's the correct one.

      I did have a nerve block last time. I can honestly say that I didn't have pain when it wore off, discomfort but no real pain.

      Lots of twinges and twangs as nerves sorted themselves out and my leg took on a life of it's own where every now and then it would flick but I kept up with the medication for the first 5 days the just took ibuprofen when needed.

      Looking forward to getting it over and done with..... my only dilemma, being a gardener, is do I sow my flower seeds in the greenhouse before the op or not.

      Probably not and hope that there'll catch up if sown later.

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    • Posted

      Yes, the last few days beforehand are really quite stressful, I think the anticipation is almost as bad as the actual event. I think it helps to have been through it before, but maybe three times is more than once too often!

      I'm a very amateur gardener - sowing coleus seeds is about the extent of my expertise - but I do love flowers and much admire those who can make them grow. After I had my right foot done two years ago subsequently my husband pushed me around Keukenkof in a wheelchair to see the glorious tulips.  This time I'm hoping that by Easter I may be back on my feet sufficiently to be able to get around at least part of the grounds under my own steam.  The gardens are open to mid-May, but it's so difficult with this surgery to know how long the recovery will take, so it may yet be a wheelchair job.  To be fair, Keukenhof is organised with such Dutch efficiency that the wheelchair access is superb, so it would still a great experience.  At least I should be able to drive there by then, which will be something. At the moment even hobbling around the house is quite an effort,  so it's difficult to imagine striding around the tulip fields for a day.....

      Just have to keep telling yourself that having normal painfree feet will make it all worthwhile it in the end! 

       

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    • Posted

      Hi I hope you don't mind me joining in. My name is Ruth and I have been following your posts. I am due surgery on Feb 28 (day after my 50th birthday!) I'm due a bunion correction 2nd toe hammer correction and 3rd and 4th toe re alignment. I'm sorry I haven't got my head around the medical terms for all this. I wondered if you'd mind me coming back to you over the coming weeks as i'd like your input as someone who is experiencing this. I'm worried about getting upstairs and I'm thinking I'm never going to sleep at night for starters! Any advice would be gratefully received.

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    • Posted

      You are most welcome!  I live in a house which has four long flights of stairs, so I really do understand your concern on that score. How you cope with them initially will depend very much on the surgical procedure being used as some permit weight bearing post-op and others don't.  My first op was strictly NWB, and as I am useless with crutches I decided the only way up to my bedroom was on my bottom!  I did not go downstairs again until a week later after I had been told I could weight bear with a surgical shoe.  As you have to spend the first couple of weeks more or less completely immobilised to elevate and ice anyway, it's probably best to avoid the stairs completely  and try to get everyone else to run around for you, if you possibly can.

      As to sleeping, I have found a bed cradle to be really helpful as it keeps the bedclothes off the foot, so I worry less about getting my foot entangled in the duvet or weighed down by it - it's very important to keep all pressure off your operated toes in the first couple weeks.  Especially important if you're going to have K-wires. This time I've also invested in a foot rest pillow, and this has been a vast improvement on using standard pillows to keep my foot elevated. Much more stable, so you don't wake up in the middle of the night to find them all on the floor. You can get both these things off Amazon.

      Are you having both feet done or just one? I hope you enjoy your last few days of freedom, especially your birthday!

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    • Posted

      Hi Amanda

      I'm only having the right foot done he has said I can put my heel down and with crutches I guess I will be fine.

      Now wondering if it will be cancelled anyway! I've picked up a sickness bug so as my op is Wednesday its not looking good sad

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    • Posted

      Oh dear....poor you, hopefully you'll be recovered enough for the operation to go ahead.... I was supposed to have my left foot done last Tuesday but it got postponed until next Thursday (1/3).

      I can only speak for myself but after waiting so long  and getting the phone call for the original op date I'd syked myself up, then to get it posponed was a bit of a knock back.  My husband has been poorly all week, finally got him to visit the Dr this morning as there's been no improvement...  Dr says it's  gastroenteritis so I'm hoping I don't catch anything from him.

      All being well we'll both be recovering at the same time....

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