Failed bunionectomy and hammertoe surgery

by Corrine
(Washington )

Hello I had surgery on my right foot in July of 2012 to fix my bunion and correct the hammertoe on my second toe. This was quite an extensive procedure and my doctor even used donor tissue. The end result was a pin sticking out of my second toe and a plate with screws on top of my foot behind my big toe. Sadly my foot is 100 percent worse now than it was when I thought I couldn't stand the pain anymore and decided to have surgery!! I know there is always a risk for failure as all feet and people are different and there is no way for a doctor to know what the outcome will be they try their best and I would never blame them for what is unforeseen. That being said here is my problem- the second toe that was corrected is now greatly swollen in the middle area red and dry skin on top the skin under all my toe nails is growing in thick and is pushing my toe nails up this is also very painful!! The second toe has now caused my third toe to slide under the second toe and cause a hammer toe that way. My bunion is back and I think one of the screws is popping up. I am in constant pain and just treat the symptoms daily just to get through work. My quality of life is zero! It's work then home then lay down foot up and ice. I have just made an apt with a new doctor to get a second fresh opinion but I was just wondering what your thoughts might be. Have you ever heard of all these problems arising from these surgeries or am I really unique case! Thank you for your time, Corrine

RESPONSE

Hi Corrinne,

As you rightfully point out, no two people are the same and no two bunion or hammertoes are the same.

Complications are part of the risk every one undertakes when they consent to surgery.

You do not give much in the way of background history, such as your age, activity level, other medical conditions that you may be suffering from and your weight. So I do not know if any of those factors may have played a role in the way your foot ended up.

I also do not know if there were any complications during the healing process, such as infection, or you falling or dropping something on your foot; things that could have adversely affected your outcome.

After mentioning all that, the short answer to your question is yes, problems like yours happen all the time. I cannot quote any statistics but if you search around this site, for example, you will find numerous people who have written concerning the poor outcome of their foot surgery.

I would be curious to know what kind of "donor tissue" he used, I am thinking bone graft, but am not sure.

The only good news that I can extrapolate from this is that you were in so much pain prior to the surgery, that you were justified in having surgery, as many people make the mistake of having this type of surgery and are only having marginal pain.

So what does all this leave you with?

I believe the pain from the bunion and the pain from the hammertoe should be dealt with separately.

For example, if one of the screws is protruding, then it may have to be removed, assuming the osteotomy site is completely closed (it has been close to three years since the surgery). There is also a chance that you are having pain in the bunion, not only because it moved back over, but the osteotomy site may have never closed even with screws and a plate.

The second toe had a k-wire inserted in it which makes me assume the surgeon attempted to fuse the joint straight and in general, your symptoms do not occur with type of procedure, but the bad news is a swollen toe three years down the road is going to stay swollen and now the third toe is starting to roll underneath it, causing you more pain.

Getting a second opinion is the right choice as you need a fresh set of eyes and ideas to evaluate your foot. I would even go further and state that a third opinion might be in order, particularly if further surgery is recommended.

One of the pitfalls that people run into is having repeated surgery on the same problem and each subsequent surgery makes matters worse. If for no other reason, you end up with more scar tissue and the bone structure is harder to "work" on with each additional surgery.

Since by your own admission you are now 100 percent worse off, I would think reconstructive surgery will be offered to you (I am only guessing here, since I cannot actually examine you). The most important question to ask the surgeon is, what is the downside to any of the proposed surgeries. As bad as your foot is now, it may actually get worse with additional surgery.

I wish I could be more helpful, but from the other side of the internet it is very hard to give specific recommendations since I do not know what your foot actually looks like since the surgery, nor do I know of any extenuating circumstances that may lead to this poor outcome.

Good luck!

Marc Mitnick DPM
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