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The response to the question below was authored by Marc Mitnick DPM

1st MTP fusion

by Gabriella
(Miami FL)

Hello, I had a fusion of my 1st MTP left foot. I also had a sesamoid removed in March 2013 that was fractured. The surgeon did a cheilectomy as well. I just saw my surgeon on Monday, and he said to start walking on it with out the boot in my house. Well, I got home and was excited to get out of the boot and walk, but when I do it feels like the diagonal screw that was placed in there( along with the plate and screws) is going to push out thru the bottom of my foot between my big toe and the one next to it. I wish I had walked when I was at the doctors office so I could ask him about this. He did say everything looks great on the X-rays and I can not do any damage if I walk on it. But when I do, it hurts like heck..Will this go away ? Thank you for any advice/help you may offer..

RESPONSE

Hi Gabriella,

I may be stating the obvious when I say this, but this is a conversation you should be having with your surgeon as he is the one best familiar with your surgery. I think calling the office and telling them what kind of symptoms your are having would be the right way to go.
I am curious why it took nine months for you to begin bearing weight on the foot. Had there been any complications with the surgery?
In any event, I would have thought once you started to walk without the

cast, the foot might have felt a little "weird" but certainly not painful as you describe.
If the diagonal screw had penetrated the outside of the metatarsal/big toe, closer to the second toe and second metatarsal, then your complaints may be real. The problem with these types of surgery is that you end up having a lot of hardware placed in a very confined location and this can create problems as there is very little margin for error in terms of a screw or even a plate aggravating surrounding tissue.
Assuming every thing is alright with screw and plate placement and it is just a matter of getting "used" to your new big toe joint, then some physical therapy may go a long way in making you feel normal again.
Keep in mind when you have a fusion of your great toe joint this is going to change the way you ambulate. For some people this is more of an issue than for others. Factors like age, weight, athletic activity will all be a factor in determining what kind of problems, if any, you have going forward. The decision to fuse the great toe joint has to be made on the factors I just mentioned, so I assume your doctor took your situation into account when he decided to fuse the joint.
Like I said earlier, make him aware of your pain as he is the only one who will be able to remedy it.

Marc Mitnick DPM
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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

Harvard Health

Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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(location unknown)

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Unknown location

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Poland

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Seattle, WA

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New Jersey

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Evansville, IA

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San Diego, CA

Dr. Mitnick, Just want to say thank you so very much for your quick response and very informative reply! After reading what you had to say, I called the doctor's office and was able to get in and see him the same day as my injury. Toe was x-rayed and luckily, it is not broken or fractured. Very badly bruised and will probably lose the toe nail. And although my toe and toe nail are still very black and blue and very sore, they ARE both starting to feel a little better. So again, thank you! I am so very happy that I came across your website. The service you provide is outstanding and immeasurable!

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Albany, NY

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Whichita, KS

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Boston, MA

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Colorado

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Colorado

Wonderful advice

by: Anonymous

This is the best site for foot problem info.

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location unknown

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location unknown

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Wisconsin

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location unknown

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North Carolina

Many Thanks Dr Marc!
Thank you for your response. It sounds like a good plan to me. He did not cut the wart out first ...

KG

location unknown

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Florida

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location unknown

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New Jersey

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a mom

location unknown

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Bellevue, WA

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Jodi

location unknown

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