Artificial toe joint - any knowledge?

BigSpecs

I have always been a keen hockey player (field not ice) and have suffered several blows to the feet as a result. In particular, about eight years ago, I went through a phase of getting hit repeatedly on my right big toe (by accident in case you were wondering) this caused a great deal of pain at the time (I lost the nail for a while and presume I broke the toe but never had an x-ray to check) but was eventually forgotten about.
Until that is I developed a sore patch of skin above the same big toe when I'd been out cycling (this was about two years ago) This seemed to have happened because of a lump that had developed which was rubbing on the upper of my cycling shoe.
I went to the chiropodist and he diagnosed "Hallux Limitus" basically arthritic changes to the toe joint due to the trauma. This had caused swelling of the joint.
He offered a prognosis whereby this would get progressively worse and more painful. It would eventually start to hurt as I walked (it now is, although not really pain, more discomfort) I have to be very careful buying shoes aswell so as they fit well.
He said the treatment would initially be nothing until the pain worsened and then an orthotic (insole) to stop the joint bending as I walk. Then cortisone injection or two and then an artificial toe joint! I asked him how long this would take to occur (I am 33) expecting him to say something like by the time I am 80 and he said probably the next 5 years! Sheet!
So, the question is, does anyone know about such things? is this prognosis correct? Is there anything I can do meantime? Would early intervention help? Are the toe joints any good?
Any help much appreciated.

ut_och_cykla

My mum (very old non-cycling lady) had something similar on her 3rd toe. After a failed straitening/pinning op she elected to have it removed - having been told earlier this would be impossible and leave her with 'balance' problems! She naturally has no probs with her balance and doesn't miss her previously permanantly ulcerated toe at all.
My feelings would be - don't faff about - amputate it! (tho' naturally you should follow medical advice given...)

yakk

Hi, you've been given a very pessemistic prognosis 9the timescale, anyway). The footwear/orthotics should help a lot, and should it flare up then the cortisone injection should work well. Your podiatrist (or a physio) should be able to show you some mobilising exercises which will help if it starts to stiffen up on you (this is the appropriate early intervention).
You shouldn't be a cripple in 5 years, and certainly shouldn't need a joint replacement by then!
It might be a good idea to avoid high impact stuff, unless you are wearing very supportive boots (like walking boots that don't bend at the ball of the foot).
You've probably been given advice about changing your cycling shoes to ones that don't rub your big toe. Cycling shouldn't be a problem for you as the shoes are almost rigid and shouldn't stress the big toe joint.

Good luck.

Yak

Yorkman

ut_och_cykla wrote:

My mum (very old non-cycling lady) had something similar on her 3rd toe. After a failed straitening/pinning op she elected to have it removed - having been told earlier this would be impossible and leave her with 'balance' problems! She naturally has no probs with her balance and doesn't miss her previously permanantly ulcerated toe at all.
My feelings would be - don't faff about - amputate it! (tho' naturally you should follow medical advice given...)

You never amputate the big toe - that's the principal toe for balance.

ut_och_cykla

Yorkman wrote:

ut_och_cykla wrote:

My mum (very old non-cycling lady) had something similar on her 3rd toe. After a failed straitening/pinning op she elected to have it removed - having been told earlier this would be impossible and leave her with 'balance' problems! She naturally has no probs with her balance and doesn't miss her previously permanantly ulcerated toe at all.
My feelings would be - don't faff about - amputate it! (tho' naturally you should follow medical advice given...)

You never amputate the big toe - that's the principal toe for balance.

Sorry - I'm sure no end of people adapt to a full and active life after losing other sometimes larger parts of their body. I know how much trouble, pain and shoe choice probs my mums toe caused her and how happy she is not to have it now!

I'm sure losing a big toe presents balance problems, but nothing that can be be got used to. Can't imagine a fixed or agonising toe helps much with balance either to be honest

G man

I believe that amputation of the big toe is not indicated for arthritis of this joint. It is extremely important for walking. Rigid soled shoes reduce the movement of that joint and therefore the pain. If orthotic insoles / rigid soled shoes fail to control symptoms, I believe the surgical options include trimming the bony spur off (to improve movement) or fusion of the joint, which should cure the pain.

BigSpecs

Thanks all for your help. I don't much fancy losing the toe and I am also of the belief that it (along with the little toe) are the ones important for balance etc.
One of the things I am not sure of is this. If trimming the bony spur is a help to movement/ alieviation of pain etc, when should I be getting this done? Would sooner intervention be better?