I had surgery to my right foot at the beginning of November. This was to re align bones in the midfoot, correct a severely deformed big toe and extend the achilles tendon. The big toe had two screws inserted. Two screws were inserted to the mid foot and I had a titanium screw inserted in the ankle. As far as I understand, the achilles was snipped into to extend its length and then pulled up and attached to the calf muscle. Initially a bone in the midfoot failed to heal, but eventually healed after 5 months. I was in a full cast for 4 months with partial weight bearing. As a result of being immobilised for so long, the toe joint became frozen. On x ray it was discovered that a screw in the mid foot was too long and had come out the other side of the bone, causing inflammation. On 21st April I underwent manipulation of the big toe under anaesthetic, administration of a cortisone injection into the toe joint and removal of the screw that was too long. I returned for a check up and x ray 3 days later. It was found that I now have a fracture to the base of the proximal phalanx...one assumes that this is as result of the manipulation 3 days ago.As a result of the fracture I cannot move my big toe ...so does that mean that the manipulation will have been worthless? Will there be any long term affects to my recovery? Will the steroid injection still be helpful? How can a manipulation by a surgeon resulted in a fracture? Is there a problem with the strength of my bones or was the surgeon too energetic? When would you recommend starting physiotherapy to maximise recovery of movement?