painful purple foot

This is Day 4 after surgery

4 weeks ago I had a lapidus bunionectomy with a hammertoe repair and an Akin ostometry. The toe next to my big toes cracked when the doctor put in the screw and he had to put in pins (temporary) to hold it.

From the time I got home, my pain was terrible. Especially after standing up. My foot would immediately turn purple and the pain was through the roof. About five days after surgery the foot was so swollen and an infection started. By the way, I had a nurse coming to my home each day to check on condition and change my bandages. She noticed the infection area and marked it each day as it grew. I went into the hospital and after only one bag of antibiotics my foot wasn't swollen and the redness was almost gone. Most of my pain seemed to me relieved, too, except for when I put my foot down. As time past my foot started to hurt again too even when not down.

So, here I am at four weeks, with a foot that still goes purple when I stand. I tried to go to my office job last week on crutches, but even after trying to sit with my foot up next to my desk, I didn't last long. By 11 am it the pain would start and by 1pm it was too much to handle and I left work early all three days I went in.

I really need to work full days. My doctor doesn't talk to me. It is so weird. I didn't know about the pins in my foot until a doctor in the hospital asked me whether my surgery doctor told me if he was going to take them out because they were too long to keep in permanently. The hospital doctor said the surgery all looked really good - so that was some good news - and the shape of the foot is exceptional - nice work. However, I have seen my foot surgeon four times since the surgery and each time he tells me something completely different from what he told me the time before. Before the surgery he said that post op would be two weeks no weightbearing and then six weeks in a boot. After the surgery he said that because of the crack, he wanted three weeks no weightbearing (which I did completely). At the end of three weeks I asked him if I could start putting weight on the foot in the boot, and he didn't answer he just said that he would take xrays the following week and that I should bring a tennis shoe in. So at the almost four week point, I showed up and he didn't do xrays, only grabbed my foot and moved the bones around and told me to bring a tennis shoe in and he told be to stop using the crutches. He said he would do the xrays the next week instead. So I have come home and started walking on the foot. It just swells up and turns purple and it doesn't seem to go flat on the floor. It hurts and the big toe doesn't work (I think he must have done something so that it won't move anymore - I wish he would just explain everything he did in there). By the way, he said there are about 5 permanent screws in there fusing everything.

The only explanation for the purple foot from the surgeon is that he did a major surgery with nearly 5 different procedures and that is why it turns purple. He also said my foot would hurt for a very long time. Before the surgery he said it would only hurt alot the first few weeks.

Will the purple pain go away anytime soon? What is the normal time for the purple problem to go away after surgery? Four weeks seems like too long. It also seems awfully early to be walking in a regular shoe after only three weeks after he had originally said I wouldn't be in a regular shoe for two months? I opted to just stay in the boot because my foot just plainly hurts too much for a shoe. What is going on with this guy? Why is my purple foot not addressed?

Hi,
You did have a lot of surgery in a small area and because of that you are going to have a lot of swelling and discoloration. Since I know nothing else about you it is hard for me to tell how long this problem will last, but once the protruding pins are removed and assuming there is no infection, you should start physical therapy. Once you start therapy you should begin to see a dramatic improvement in the color, shape and function of your foot.
BTW, demand that your doctor answer all questions that you have and if he or she is inconsistent with the advice they are giving you, let them know you are not happy with your treatment. Doctors never like to hear that their patients are unhappy, it makes them nervous.
Marc Mitnick DPM