Still very swollen after 6 months

by Nancy
(Boardman, Ohio)

My surgeon said that after having my bunion removed, that my foot may stay swollen for 6 months. As the 6 month date arrived, my foot remains very swollen and I am still in a surgical shoe. My podiatrist was VERY concerned about this and after seeing my foot, she did a series of x-rays. The x-rays showed my surgical foot to have 3 fractures in the 2nd, 3rd and 4th metatarsal area and the bones are now displaced. Is this a common/noncommon complication of having a bunion removed. My foot is worse now than before the surgery. Any advise would greatly help. My podiatrist has my foot in an air cast.

RESPONSE

Hi Nancy,

In short, your problem is not very common at all. I am at a loss as to how you fractured the second, third and fourth metatarsal bones, unless you had some kind of trauma during the recuperative period and I am sure you would have remembered either falling or dropping something very heavy on your foot.

The only other thing I can think of is perhaps the type of post operative shoe you were wearing, destabilized your foot and you suffered three stress fractures, which even though I have never personally seen it, I suppose if you are walking on the outside of your foot to keep pressure off the bunion, these fractures could possibly happen.

Even if that is the case, I do not see how the fractures would have displaced. Usually simple stress fractures are nothing more than "cracks" in the bone. Essentially, there would have been trauma to cause the fractures to displace.

So, now along with a bunion that is apparently still bothering you, you will also have to deal with the three fractures. Depending on the distance of the displacement of the fractures, some or all of them may require surgery.

Keep in mind I am only an outsider looking in, but I would imagine you would be better off being completely non-weightbearing on the affected foot, for the simple reason, if you sustained three stress fractures simply walking around in a surgical shoe, then I cannot imagine how your problems are going to resolve by bearing weight on the foot.

As a side note, I do not know your age or any thing else about your medical history but I am wondering if you suffer from extensive osteoporosis or perhaps have a metabolic problem that is making your bones subject to easily fracturing. This may need to be investigated as well.

This issue has been going on for six months and I am sure you are anxious to wrap this up, so it would appear to me that your doctor is going to have to be more aggressive in your treatment. If the fracture displacement is such that there is little chance of the fractures healing on their own, then you may want to have the surgery discussion, sooner, rather than later.

Marc Mitnick DPM
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