Week 7 osteotomy bunionectomy

by Micky
(South Africa)

I don't know if anyone has had or is having the same problems as I?

I've had both feet done on the 12 Jan 2016, worst decision I've ever made! Week 3 I went back due to foot pain and inflamed wounds, my surgeon took X-rays and told me I'm doing so well I only need to wear my splints at night., allowed to have a normal shower, I may drive and wear normal shoes. Needless to sat I followed his instructions as he's the professional and a surgeon with a brilliant reputation. Needless to say that I ended up at my GP a week later with severely infected wounds, very much in pain and thoroughly miserable. I was still walking on the sides of my feet, kept my feet up and iced. 2 courses of extremely strong antibiotics, minimal movement, keeping my wounds clean it has cleared up nicely, still struggling with the right foots wound to close but at least it's not infected anymore. They still swell up quite a bit but I seem to have developed other problems! I have limited flexibility in my toes, my big toes are completely stiff and I have the most dreadful pins and needles in my feet and sometimes in my lower legs. I still can't wear trainers and struggle with normal through the toe sandals. Prior to my op I used to gym 5-6 times a week, eat very healthy, don't smoke and don't drink.
Is there anything I can do to stop the pins and needles? I do realize that I would need physio in order to get flexibility back in my toes. I'm supposed to go back to the surgeon in March but I don't trust him :(
Please I would appreciate any suggestions/ advice

Warm Regards
Micky

RESPONSE

Hi Micky,

Even though a good many surgeons do it, I never understood the reasoning behind doing an osteotomy on each foot at the same time.

No matter how successful the surgery is, at the end of the day, you still have a broken bone on each foot. When only one foot is done, the patient can at least lean on the non-operative foot in order to protect the foot that has been operated on and thus give that foot its best chance of healing without complication.

In your case, the infections that developed really had nothing to do with both feet done at the same time, but instead just occurred as a complication of surgery.

The pins and needles that you are feeling in both feet, however, may be the result of having both feet done at the same time. Walking in a "Frankenstein" type gait trying to protect both feet may have done some damage to your lower back.

Assuming you get back to a more normal gait quickly and too much damage has not occurred, you can probably expect the pins and needles to subside

The stiffness in the big toes happens quite frequently in bunion surgery and physical therapy is indicated to try and increase the range of motion, however, you want to start physical therapy as soon as possible. The longer you wait, the less successful the therapy will be. You are at a disadvantage simply because of the infections, the physical therapist may not want to start therapy until the wounds are completely closed, so that is only going to delay things.

One of the best things you can do in the meantime, assuming you have the surgeon's permission to do so, is to walk around the house without shoes. By walking barefoot, particularly going up steps, you will force the toes to bend upwards and hopefully will start to create motion. This is what I have my patients do. (FYI-walking barefoot would only be allowed if the osteotomy sites are completely closed, otherwise you could do damage to the surgical site). In light of that, speak to your surgeon about starting physical therapy as soon as possible.

Marc Mitnick DPM
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