"Shifting" of the Great Toe 6 weeks after Tightrope Procedure
by Monie
Hello, After my followup visit my doctor told me that my Great toe is shifting again. Looking more like a bunion. I'm only 6 weeks post-op. Is this normal? She thinks maybe the rope has stretched??? She wants to re-xray in 3 weeks to make sure it has stopped. My xray on August 31st also showed a very slight shift that she wasn't aware of until my appointment on September 14. Previous xrays showed my great toe in perfect alignment. I'm so disappointed and confused how this could happen so soon. Can I do anything on my part to prevent any further shifting? Any info or adavice you can offer will be greatly appreciated. Thanks. ANSWER Hi Monie, Since wire is used to perform the tight rope procedure I do not know how it could stretch unless it was a very low tensile strength which then should not have been used. My "guess" is that the wire broke at its insertion either into the first or second metatarsal bone and thus is not "pulling" the first metatarsal closer to the second. If it has not actually broke then it has loosened up. You could try wearing a bunion splint to keep the toe straight and maybe stay nonweightbearing to see if the attachment will fuse, but the reality is if there already has been enough stretch then the attachment is probably doomed. If it turns out that the tight rope has failed then you will have to consider additional surgery. I would think re-doing the tight rope would not be an option because every time you drill holes into bone, it inherently weakens the bone and you could end up with a fracture. From strictly a theoretical standpoint, as I cannot examine you nor have I seen x-rays, I would think you would be a candidate for an osteotomy procedure, whereby the the first metatarsal bone is realigned and then set with screws or k-wires. My best advice is if you have faith in your surgeon, then go with what she recommends. If you have lost confidence or perhaps am unsure of her recommendations, get a second opinion from another doctor in your area. Marc Mitnick DPM a href="http://www.foot-pain-explained.com/privacy_statement.html#askthedoctor">DISCLAIMER
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