Extreme pain in foot, numbness, at times feels like frost bite in last 3 toes.

Hi my name is Heather,

In January of 2009 I had a tight rope bunion surgery, with a temporary pin placed in big toe to correct my bunion; which was causing me pain. I am a hair stylist so, I stand for 8-10 hours 4-5 days a week. Although, I took off 6 weeks of work at the time to heal. After the dressing and pin was removed and I began to put full weight on my foot I noticed numbness in my last three toes at times it felt like frost bite and what felt like an electric shock shooting down my foot and up my ankle. The pain got increasingly worse. Went back to the doctor, he ordered an E.M.G., a C.T. scan and an x-ray. He then thought it was carpal tunnel. So, I then had that surgery done in October of 2010. Now the pain is so bad I am taking pain medication, and am in constant pain. When looking over the x-rays to figure out what was going on, the doctor and I noticed that the bunion was now not only back but actually at a worse angle than when I had the first surgery. At this time I voiced concerns about this, I also asked why I could see the titanium button in the x-ray but not the anchor. And whether or not he should have even done the carpal tunnel surgery to begin with. At which time I was hurried out of the office and told to have another C.T. scan scheduled and that we would go from there. I signed to have all my records and x-rays released to me. Upon looking at the x-rays I then noticed you can not see the anchor even at just 3 weeks after the tightrope bunion surgery, while dressing was still on my foot. I began to search it up on the internet and all the images I am seeing in x-rays you can plainly see the button and the anchor. Does the anchor disappear or get absorbed into the bone after time or should I still be able to see it? Could they have actually not put the anchor in at all? And was the pin which was removed actually holding my bunion in place at first. Once it was removed the pain came on gradually and after the carpal tunnel surgery it got much much worse? I appreciate your input, I have had a second opinion, however he would not comment much because he had not done the tightrope bunion surgery recently and would not say for sure whether I should see the anchor still or not, he recommended I ask to see the Operating room x-rays to see if you can see the anchor when they first put it in. He thinks it is nerve damage that is causing the pain not the bunion, however he said there is nothing surgically that can be done about this. I appreciate your input.

Hi Heather,

If the tension wire is taught then I would assume the anchor is still there, it just cannot be seen. However, if the angle between the first metatarsal bone and second metatarsal bone is wider then it was just after surgery, it would be my opinion that the wire did not hold. Keep in mind this has nothing to do with the movement of the big toe towards the second toe (at least not directly), but rather the distance between the first and second metatarsal bones. Although you can actually measure the post op xrays with the recent xrays, a doctor would be better qualified because of factors such as nuances in the way each xray was taken.

As far as your nerve pain goes, if you did not have it prior to your bunion surgery but had it afterward, then I would assume it was a complication of the surgery such as nerve damage to the nerves if you had a tourniquet on your ankle during surgery or if you were in a cast after surgery. My point is I do not know if I would have jumped into tarsal tunnel surgery so quick and since you are still having nerve pain, chances are it was not a tarsal tunnel.
You really need to get a second opinion locally to find out what is truly going on. Find someone who will talk to you and look out for your best interest as opposed to someone who might be trying to protect your surgeon. This may mean traveling a distance but since you apparently are still in a lot of pain, it will be worth the effort.
Marc Mitnick DPM