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The response to the question below was authored by Marc Mitnick DPM
Complications from Neuroma surgery (3 neuroma's removed)
by Janine V
(Austin, TX)
Went back to Podiatrist (patient for 9 years) and asked what we could do for my foot..besides the still tender pain (6 months post op)...I now have my 2nd left toe sitting on top of my big toe. I have small bunions, but they are not the reason. The podiatrist who did the surgery asked what my foot looked like before the surgery. He is the only one that has treated me the last 9 years..and I had been to him around 6 times in 1 year. I was alittle taken back. My toe was slightly separated from the big to..He mentioned that "I should have had you massage the foot after the incisions were removed (over 5 1/2 months ago). Asked what can be done. Sure it looks horrible (deformed) but it is also painful too, I have no feeling in the top of the toe, but the sides and bottom alittle. He really didn't know. He suggested PT but didn't think that would work. Then he suggested a couple of other surgeries but didn't seem very confident either.
I went for a 2nd opinion today to see what this doctor said as I need to find relief. He suggested putting an incison either shortening the toe, or making an incison and putting in a pin and then in 6 weeks removing the pin. Said I would never be very be that flexible (I'm not flexible now either)...he called it soemthing like a wisiotomy. I hated to ask him how to spell it...
Have you heard of anything like this before?
The 2nd doctor asked me if I wanted to have him call the first doctor and tell him..I said no...as I didn't want to hurt his feelings. I did get my medical records from the doctor who did the surgery and gave them to this 2nd opinion doctor.
I'm curious if since I was told it would
Thank you!
Janine
You have always been so helpful (I'm the person who wrote about being 15 weeks post op)...
ANSWER
Hi Janine,
This is where your problem starts to get dicey. Theoretically, you will need more surgery as your foot looks horrible and you are in pain, but, sometimes too much surgery, although everything sounds good on the drawing board, does not always end up as planned and the patient either has the same amount of original pain or even more pain.
The word you refer to is "osteotomy" where the bone is surgically broken and then fixated in a different position.
That type of procedure would be to create better alignment of your toes, but I think your first concern should be the original neuroma. Are you still having neuroma pain? If the answer is yes, then you may have to go to someone who will have to make an incision on the bottom of the foot in order to have better access to the nerve and be able to remove it.
We generally do not like to make incisions on the bottom because of the chance of scarring, but in extreme cases it becomes necessary.
I think your best course of action would be to get rid of any residual nerve pain, then deal with the abnormal alignment of the toes, only if you do not like their appearance of if they too are causing you pain.
My point is, just correcting the alignment of the toes will probably do nothing for any nerve pain that you are still having.
Don't be afraid to get a third opinion.
Marc Mitnick DPM
DISCLAIMER:
Comments for Complications from Neuroma surgery (3 neuroma's removed)
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ADDITIONAL REFERENCES
University of Rochester Medical Center
American Academy of Pediatrics
Columbia University Department of Rehabilitation
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