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Had big toe fused and arthritis relief surgery, x-ray showed broken pin migrating into flesh, have numbness

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General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Hi XXXXXXX XXXXXXX is my name its 10 days since I had my big toe fused for second time. 10 years ago had arthritis releif surgery on right foot ,no mention of fusion before surgery but big toe so bad fusion required, after, an apology that big toe was so bad only option.I was 52 y old then ,been a dairy farmer all my life. Two pins were inserted in a cross formation. Recently pain sent me for an xray to reveal one pin broken and migrating into flesh. Saw new man,advised pins removal and plate and screws.After op told one pin still in foot ,its the broken one half in bone half in flesh.Have numbness still and worried all my problems are not resolved.I look forward to your advice,thank you XXXXXXX
Posted Tue, 10 Jul 2012 in Bones, Muscles and Joints
Answered by Dr. Shanthi.E 5 hours later

I am sorry that you are dealing with such a frustrating situation. Let me help you to the best of my knowledge.

In my opinion, the entire surgery on your big toe has to be redone. There is no way that the remaining pin be left in the bone and flesh. It has to be removed by all means. Only then will the pain and numbness subside.

Please go in for a revision surgery with an expert orthopedician who can perform this without any failure, who can see to it that all the remnants of the pin are removed and the fusion is done correctly.

I wish you a speedy recovery.

Please do write back in case you have follow up queries.

Above answer was peer-reviewed by
Follow-up: Had big toe fused and arthritis relief surgery, x-ray showed broken pin migrating into flesh, have numbness 5 hours later
Dear doctor,I am so distressed.My dairy buisness is at risk without my input and I have travelled 320km to melbourne for specialist surgery,my recovery is here as well and it is now 9 times I have had general anesetic in 10 years.I am to see specialist in two days what sort of questions do I need to ask?The xrays before and after clearly show broken pin still in place.The surgeon saw me for only a minute after op said something about would have had to cut into bone.The op took about 50 min with an assistant and I paid as a private patient,very distressed XXXXXXX
Answered by Dr. Shanthi.E 2 hours later

I am distressed too with the amount of negligence shown by doctors in your case. It is the responsibility of any operating doctor to know the actual purpose of doing the surgery and getting at the right post operative results.

1. If you are going to XXXXXXX the same the specialist who did the surgery, you need to ask him as to why the pin was left half way in the bone and flesh. A diligent doctor would do a diligent surgery.

2. Please ask for the option of local anaesthesia or regional anaesthesia: if these can be used for the surgery instead of going through general anaesthesia again.

3. Do ask about what are the chances that the pin still be left there in spite of undergoing a new surgery for the same.

4. Ask if the specialist is going to remove only the left over pin or if he is going to remove the plate and screw and put in a new one again too.

5. You have to be explained clearly as to what surgery you are going to undergo again. Please give a valid informed consent. You have the right to ask anything to the doctor before giving the consent.

6. You should also know about the prognosis after the surgery, if it will cause a bad fusion again or not, if you can get back to normal life at least by 95 to 98% even though not 100%.

7. Ask about when you can get back to normal routine work after the surgery.

8. You are paying for the surgery and consultation. You still got a long way to go in your dairy business.

I wish this time all problems can be fixed once for all.

My sincere wishes to you.

All the best.

Do write back in case of any query that you may have.

Above answer was peer-reviewed by
Follow-up: Had big toe fused and arthritis relief surgery, x-ray showed broken pin migrating into flesh, have numbness 5 hours later
Dear Doctor,Thank you for your reply,regards XXXXXXX
Answered by Dr. Shanthi.E 58 minutes later
Thank you too XXXXXXX

Take care of yourself.

Wish you good health.

You may ask me a query at this link in future, if you have any queries.


Above answer was peer-reviewed by
Follow-up: Had big toe fused and arthritis relief surgery, x-ray showed broken pin migrating into flesh, have numbness 3 days later
Dear Doctor,I met with operating surgeon and his asstiant.They both said that to remove the broken pin,which they said is in bone and flesh,would have given my foot a worse outcome than what I face.They said the numbness would go away with time and because it is revision surgery I would need another 5 weeks recovery with a special shoe which I now have.They we adament that it was better to leave the pin where it is.I explained I was not convinced.They said if after time I would like it removed I would need a general not local operation and recovery would be 2or3 weeks as the plate and screws would not be touched.I am in two minds ,should I seek another specialist for advice or would he be reluctant to say too much.Then again do I just put up my with lot!Thank you XXXXXXX
Answered by Dr. Shanthi.E 46 minutes later

I am glad that you spoke to your operating surgeon.

Let me give you some clear suggestions that will help you.

In my opinion, you should go ahead with the surgery.

As the surgeon told, let them leave the plate and screws untouched. We should not leave the retained pin inside as it is. Please ask the operating surgeon to remove it. We may have to abide and go by general anesthesia as suggested by the surgeon and the anesthetist.

It is not a good idea to seek another specialist now. Discuss with your present doctor patiently. I am sure he will agree with you and help you out.

Meanwhile, continue to wear the special shoes that you have.

Recovery time for your surgery should not take more than 5 weeks.

For the numbness to go away and for a faster recovery, you should be put on nerve supplements like Neurobion forte and Chymoral forte. Your operating surgeon will know about this and he will put you on this.

Overall, get the retained pin removed and let the plate and screws be untouched. The outcome of the surgery will be good as per me, better than what you are facing now.

My best wishes to you.

Do write back for more discussion on this.

Thanks and take care.
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