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Suggest Treatment For Severe Pain In Toes After Injury

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Posted on Mon, 29 Jun 2015
Question: Hi there, I am a 53yo active female. I had hammer toe surgery at the end of February. Three weeks post surgery, I accidentally kicked the foot of the bed. The force was great enough to have heard a loud snap, followed by extreme pain. My making headway with the healing process stopped that day. Now 3 and 1/2 months later, that same 4th toe constantly gives me extreme pain. Especially, after a day on my feet (in any shoes). I had an X-ray one month ago to check for fracture, and it was negative. The extreme pain persists.
2 days ago, I had a repeat X-ray it showed progressive cupping of the distal surface of the bone. I had blood work done to rule out osteomyelitis. ROF showed WBC's in normal. I'm really at a loss for DX and/or TX. any ideas??
doctor
Answered by Dr. Dr. Praveen Tayal (2 hours later)
Brief Answer:
Due to inflammation.

Detailed Answer:
Hello,
Thanks for posting your query.
I have seen the attached report. The progressive cupping of the distal articular surface of proximal phalanx can be due to an infection or an inflammation in the area. Post operative scarring is less likely to cause a progressive cupping.
Since the WBC count is normal the most likely cause of cupping seems to be an inflammation. This can be confirmed by an MRI scan of the toe.
A hot compress and anti inflammatory medicines should help in pain improvement. In case the pain is persistet then local steroid injections can be given after confirmation of diagnosis by MRI scan.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12314 Questions

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Suggest Treatment For Severe Pain In Toes After Injury

Brief Answer: Due to inflammation. Detailed Answer: Hello, Thanks for posting your query. I have seen the attached report. The progressive cupping of the distal articular surface of proximal phalanx can be due to an infection or an inflammation in the area. Post operative scarring is less likely to cause a progressive cupping. Since the WBC count is normal the most likely cause of cupping seems to be an inflammation. This can be confirmed by an MRI scan of the toe. A hot compress and anti inflammatory medicines should help in pain improvement. In case the pain is persistet then local steroid injections can be given after confirmation of diagnosis by MRI scan. I hope this answers your query. In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out. Wishing you good health. Regards. Dr. Praveen Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal