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

swollen foot and bad pain after having a big toe operated on for a joint that had bad arthritus and a pin installed

by Steve
(sparks nv)

Big toe was operated on bone in the joint was cleaned up a pin was installed made from nickel. she is having bad pain in the whole foot and after two months her foot is really swollen after short walks ,she comes home ices it takes her meds and still is painful but most of all she is swollen bad from her toe into the ankle. Dr said the pin has moved a little. My wife asked the Dr what the pin was made of and he said nickel and she is allergic to nickel could this be the problem could it be why the pin didn't take and is moving and being swollen and so painful. thank you for any help !!!!!

RESPONSE

Hi Steve,

Your wife has two problems going on here, an apparent allergy to nickel and movement of the pin that was put in her foot, both of which lead to the same conclusion. The pin should be removed.
I am assuming the pin is implanted in the foot, meaning it is not sticking out through the skin and its original purpose was to be permanent.
Two months after a big toe joint operation, there should be some swelling and perhaps some discomfort after walking but your description sounds much worse than that.
May I also assume the foot is swollen and painful even when your wife is off her foot? If she is having a reaction to nickel then that would be the

case. If the foot is only swollen and painful after she has been on it too much then I would lean more towards the problem being movement of the pin which is no longer stabilizing whatever it is supposed to be stabilizing. (I phrase it that way because I do not know if the pin was inserted to keep the joint space open or if it was inserted after the first metatarsal bone was broken and re-set. If the situation is the latter then movement of the pin might not allow the broken bone (osteotomy) to heal and of course that would be an issue. At eight weeks most surgically broken bones should be healed.
I would be curious to know what her surgeon's response was after he saw the foot knowing it was eight weeks down the road. Has he offered to remove the pin or did he just dismiss the thing?
If he dismissed the whole thing then there may be a problem because again, eight weeks is way too far down the road to be having this kind of problem.
My best advice to you and your wife would be to get a second opinion by a local doctor who would be better at determining if the swelling and pain is consistent with eight weeks post-op or, if there is a problem going on here.

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

swollen foot and bad pain after having a big toe operated on for a joint that had bad arthritus and a pin installed

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