Not sure whether to have metalwork removed from foot

TrishaW

Hi everyone,

I've posted on here before about the big toe joint fusion I had a year ago, and my problems with ongoing pain.

My surgeon says some people can't tollerate the screws/plate and feel better/less pain if they're removed.

I'm not sure wheter it's the metalwork that's causing the pain or not so i'm unsure whether to have surgery to remove it if it's not going to help (I reacted badly to surgery last time with complex regional pain syndrome)

My gut feeling is that it is the metal that hurts but I'm just not sure whether to risk surgery again.

I can't put weight through the fusion without pain and it's making the pain in my ankles (that have full tickness OA) worse.

Has anyone had metal work removed and did it help with post surgical pain?

Thanks,

Trisha x

dreamdaisy

I have a friend with RA who had a wire removed from her ankle fusion back in July, it had worked its way loose so there was no choice. I think it's nearly healed (the meth inhibits healing) and as far as I know things are better for her than they were. DD

TrishaW

Thanks DD x

stickywicket

I'm sorry Trisha. This is a tough one for you. Sometimes all we can do is go by instinct. I guess it's a matter of how bad the pain is and how much worse it could be. I wish you luck with your decision making. I don't envy you.

hileena111

Hi
Well I have metal work in my left ankle, pins screws and a plate but its because a car knocked me down and wnet over my ankle and it was well smashed. So not quite the same as yours.
I have OA and various other things. I had a pretty awful operation when they did it. He then mentioned how long they would be in. He then saw my face He said do you not want them out?
I said "will it do any harm to keep them in?" he said no probably not unless you get an infection or something similar in it then they will have to come out.
I said "If they don't bother me I'm not going to bother them"
Well that was 6 years ago and they are still there with no ill effects. The only thing is I have arthritis there where I didn't have it before. It wouldn't have mattered whether I had had them out or not I probably would have got OA there anyway. It always goes for the weakest part :roll:
Well not the same as your but that's my story and like Sticky says I don't envy you your decision
Good Luck
Love
Hileena

OsteoAnkles

I had metalwork in my ankles after an accident 22 years ago. The advice at the time was to leave it in unless it started causing bother - no doubt there is some element of economics about it but also there is always a risk when you go under general anaesthetic.

It was in for about 2 years before some of the screws starting working their way out and poking through my skin! Inevitably I had the metalwork removed. A year after removal I was in far better shape than a year after the initial op - far less pain and discomfort. Whether or not it was solely due to getting metal removed I don't know.

Once its done its job and the bones have fused there is no benefit in keeping it in. Obviously you have to be careful after a removal op as the area will be slightly weaker but gaps left are eventually filled in with boney material - your natural stuff - and it will strengthen up. For me the recovery time was nothing like as long as after the initial op and the removal op itself was much shorter.

My tuppence worth would be get it removed. It should be a quick procedure and I guess would only need a local anaesthetic. It may or may not improve things but I can't see removing it making it worse so long as you protect it from any knocks or bumps after the removal.

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TrishaW

Thanks everyone...I'll keep you posted!
Trisha

TrishaW

Just to update you, I'm due to have the metalwork taken out next Monday 11th Jan (yikes!)
The pain has been getting worse and I'm pretty sure the pain corresponds with the screws/plate.
I'm taking 1g Vit C and 10mg Nortriptyline each day in an attempt to prevent a recurrence of the Complex Regional Pain syndrome (as advised by my surgeon and rheumatologist)
Fingers crossed that the pain goes and I don't get CRPS again.
I'll let you know what happens
Love Trisha

stickywicket

My fingers are crossed for you too. I do hope it solves the problem. I'd never heard of CRPS until a few weeks ago but I read another forum post recently from someone who had it. Good luck and please let us know how you get on.

TrishaW

Well I had the metalwork taken out of my foot 2 weeks ago, and I think it's worked! The pain has gone! And my foot feels like 'mine again....weird but it's just SO much better.

I spoke to the anethatist before the surgery about my concerns (getting CRPS again) and she was brilliant. She said to stay on nortryptyline at night for a month post op, but also to take Gaberpentin and Tramadol regularly for 3 days post op, wether I felt I needed them or not ( to ensure my body didn't 'switch on' a pain signal to my brain and lead to CRPS)

Well I did as she said and had NO post op pain at all. The stitches came out yesterday and I've been walking about today with less pain than I've had for over a year. Plus my foot is 'slimmer' without the metal plate so shoes fit more comfortably (and I haven't got a nail digging into my toe with every step!)

I'm so glad I had this done.

I've got a shoulder operation in 4 weeks so I will take the precautionary drugs (plus high dose Vit C) again to prevent CRPS in my hand. Fingers crossed!

Thanks for all your support,

Trisha

dreamdaisy

Any surgery has the element of a gamble about it but this time it's paid off! I am very pleased for you so keep up the good work with being a patient patient and taking things gently. DD

stickywicket

Reeesult! I always like a happy ending. Good luck with the next one.