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Suggest Remedy For Difficulty In Walking After Bone Fusion Surgery In Foot

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Posted on Mon, 15 Jun 2015
Question: yes i had a fusion done on my foot over a year ago now it feels like the bone is coming through my foot on the bottom right below the little toe. there is a knot there too. by the end of the day i can hardly walk it hurts so much and swells up still. thank you . XXXXXXX
doctor
Answered by Dr. Vasudha (2 hours later)
Brief Answer:
Stop weight bearing. You need to assess the operation rewsults .

Detailed Answer:
Hi XXXX,
Thanks for the query under HCM forum.
The difficulty in walking after undertaking foot fusion surgery ...has to have both physical & psychological trauma.,I understand your concern.
1 - There are a couple of possibilities for your trouble.
* Non fusion of the bones. Fusion surgery is done to prevent pain because of arthritic painful joints, where the adjoining bones to the painful joint are roughened & fused - this avoids movement of the joint & so the pain.
To allow the fusion of the bones, post operative care - in
form of non weight bearing on the operated foot is desired. Bed rest in first few days followed by movement with use of a crutches/ walking braces at least for first 6 months & starting with a stick/ foot slints support for a complete year , help in union of bones. Normal walking without support should not be unlimited any time.
. In case the above mentioned care along with dietary supplements for boney health( calcium/ vitamin D - as per doctor's advise)- it may lead to non fusion & pain Thus, displacement of one of the bone Which was fused- may cause such complaint.
* Boney spur formation- It is over growth of bone , following over stress/ friction & weight bearing at border of joints.

2. Self care- stop weight bearing till you get definite instructions
From your doctor.

- non steroidal anti inflammatory drugs available over
counter after food.
- take an appointment of your operating surgeon..
3. Your operating surgeon will examine you & get you investigated In this situation you may need investigations like Blood counts/ serum calcium & vitamin D levels/ Xray,MRI of the foot to find exact cause.
4.Treatment-It will depend on the cause found. It may contain
- anti inflammatory drugs or local injection of
steroids..
- Withdrawal/ addition of calcium & vitamin D
supplement.
-Change in supportive gadget while walking
- surgery.
- stop smoking.

I hope you found the answer informative & useful. Any follow up query is welcome.
Thanks.


Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Vasudha (34 hours later)
the doctor did take an exray back in Oct. he said the the fusion was fine. But when i ask him about the pain. he just says it because of the weight going to the other side.To me i fill i should not be in this much pain. after he told me the fusion would tack the pain away. it has move to the outside and bottom of my foot. i had a boot on for about a month after the cast came off.then nothing. after that. As soon as i started to walk on my foot the pain by my little toe started to hurt.on the bottom of my foot. when i didnt have shoes on. He told me i had to ware shoes of some kind all times . so i did. But as time went on the foot got worse even with shoes on. he gave me shots in the foot .and help some part of the foot but not by the toe. He just tells me my foot is standing up stright now. everything is good. yes it is standing up now but i have more pain then i did before. I just dont no what to do any more. surgery was XXXXXXX 29, 2014
doctor
Answered by Dr. Vasudha (2 hours later)
Brief Answer:
Altered movements/ expert advise & treatment would help.

Detailed Answer:
Hi XXXX,
Thanks for your follow up query.I am sorry to learn your sufferings by details provided therein.
In fusion surgeries movement of joint is sacrificed for pain relief & stability. So the recovery period after this surgery is long & difficult.
AS the follow up x ray after surgery confirms the fusion being successful.. the pain you have seems to be due to -
-Altered walking style-natural human tendency to avoid pressure on the operated part, & deviating body weight to the healthier part.. bringing about excessive stress & pain to healthier part. This is how I feel you started having pain at bottom of your foot to outer side & little toe.
- Involvement of nerves-The fused bone can press on the foot nerves & cause such pain./ same thing can some times happen by the screws used for fusion pressing on nerves.
- Arthritis-Arthritis of other foot joints may be caused by the stress during
movements.
Management needs to be done under expert guidance of foot orthopedic surgeon. It consists of -
-Review by the foot orthopedic surgeon for the exact cause of your pain/ assessment of muscular strength..
- X ray/ MRI to detect involvement of other parts of foot / healing of fusion surgery
Treatment -Depend on the cause. It can be- controlling arthritis of other joints ( Anti inflammatory pills/ Cortisones/calcium, vitaminD suppliments)
- removal of screws/ repositioning of bones - as per need.
-per cutaneous stimulation of nerves/Physiotherapy.
- Use of suitable shoes/ arch, foot supports ( orthotics)
- Reduction of weight.
- use of shoes / arch or foot supports ( orthotics)
I hope, the answer is both informative & helpful to you.The fusion is a surgery where motion is compromised for pain relief & stability. Naturally the recovery is long & hard. It depends on patient's adjustment in moving with fused joints without harming other body parts - with help of expert advise & supportive shoes & self helpI am sure you will be comfortable after few days of treatmentpositivity.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Vasudha

General & Family Physician

Practicing since :1970

Answered : 10398 Questions

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Suggest Remedy For Difficulty In Walking After Bone Fusion Surgery In Foot

Brief Answer: Stop weight bearing. You need to assess the operation rewsults . Detailed Answer: Hi XXXX, Thanks for the query under HCM forum. The difficulty in walking after undertaking foot fusion surgery ...has to have both physical & psychological trauma.,I understand your concern. 1 - There are a couple of possibilities for your trouble. * Non fusion of the bones. Fusion surgery is done to prevent pain because of arthritic painful joints, where the adjoining bones to the painful joint are roughened & fused - this avoids movement of the joint & so the pain. To allow the fusion of the bones, post operative care - in form of non weight bearing on the operated foot is desired. Bed rest in first few days followed by movement with use of a crutches/ walking braces at least for first 6 months & starting with a stick/ foot slints support for a complete year , help in union of bones. Normal walking without support should not be unlimited any time. . In case the above mentioned care along with dietary supplements for boney health( calcium/ vitamin D - as per doctor's advise)- it may lead to non fusion & pain Thus, displacement of one of the bone Which was fused- may cause such complaint. * Boney spur formation- It is over growth of bone , following over stress/ friction & weight bearing at border of joints. 2. Self care- stop weight bearing till you get definite instructions From your doctor. - non steroidal anti inflammatory drugs available over counter after food. - take an appointment of your operating surgeon.. 3. Your operating surgeon will examine you & get you investigated In this situation you may need investigations like Blood counts/ serum calcium & vitamin D levels/ Xray,MRI of the foot to find exact cause. 4.Treatment-It will depend on the cause found. It may contain - anti inflammatory drugs or local injection of steroids.. - Withdrawal/ addition of calcium & vitamin D supplement. -Change in supportive gadget while walking - surgery. - stop smoking. I hope you found the answer informative & useful. Any follow up query is welcome. Thanks.