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The response to the question below was authored by Marc Mitnick DPM
Edema,pain,and Discoloration
by Jill
(Milford,Ct USA)
Hello Dr M,If you remember me,I had written to you several months ago after a bench had fallen on my left foot and crushed the left 3rd toe and fractured the 2nd toe on 8/26/2010. Since then I had 3 surgeries to try to save the 3rd toe. April 2011 was the last surgery to amputate it. After that surgery I was left with swelling on the top upper and side of my left foot and a stump neuroma. I had a series of 7 alcohol shots an MRI which showed nothing,then 5 cortisone shots. Finally my Dr surgically removed a big Stump Neuroma and freed a ligament from scar tissue. 10 days later I felt flu like symptoms and under my cast a burning feeling. Dr said it was Staph infection,and 2 the next day I had a debridment done.Two days after that I wake up in agony with Cellulitis. I am hospitalized and have another debridment and a piece of bone removed. Tiny piece.5 days later another debridment,the wound vacuum would not fit because of the shape of the wound. All of my 7 surgeries were done through the same cut. Was stitched up.3 1/2 months later I am still suffering. I now have Edema all the time. Discoloration and pain still top,side and now bottom where neuroma was. i have been wearing a compression stocking and elevating and icing foot. Can't wear New Balance
with the orthodic because foot is too swollen,even went up a size in shoe. Podiatrist says 2nd toe is now a Hammer toe and can cause a stress fracture,Xrays showed none. Please help me,tell me what to do. Podiatrist says He cannot do anything else for me. I am at the end of my rope Almost 2 years dealing with this issue. I want to know what should be my next step.
RESPONSEHi Jill,
Have you ever had a vascular examination of your affected foot? If I recall correctly, you are relatively young and it seems to me that your problems (and complications) are way out of proportion to your age. That would then lead me to wonder if there is a circulation issue. Additionally, although it is a remote possibility, Complex Regional Pain Syndrome (CRPS) should also be ruled out. (You can read my article on CRPS)
I cannot be of much more help as I am on the other end of the internet and have never actually seen your foot.
If you have been using the same doctor throughout this whole ordeal, perhaps it is time for a second opinion; sometimes a different professional will take a different slant on the big picture going on here.
I wish I could be of more help, but am limited simply by the fact that I have never actually examined your foot.
Marc Mitnick DPM
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Mayo Clinic
Johns Hopkins Medicine
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Arthritis Foundation
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American Academy of Pediatrics
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Columbia University Department of Rehabilitation
ScienceDirect
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Illinois Bone and Joint Institute
Mount Sinai Hospital
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American Family Physician
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