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Hello all
I need some advice from anyone who has any experience of mid foot fusion surgery.
I had a lisfranc injury 3 years ago which was missed and i have encountered several incompetent doctors and no treatment i have had has helped. I cannot walk very far and am pretty much always in pain. My new doctor, an orthopaedic surgeon, has told me that the only treatment i can have now that will help is fusion of the mid foot which scared me no end as it sounds so drastic and she seems quite confident that it will work out. However, i have also seen her colleague who agrees this is the only option left for me but that it is too risky as he thinks that one by one other joints in my foot will need fusion as they will compensate for the part of the foot that is fused. He has refused to do the surgery as i am only 26 and he thinks that it will be downhill for me as soon as i start having surgery. These two surgeons are supposed to be the top two in my area and with such conflicting opinions i really need to hear some advice from people who have had this done. I am due to have the surgery next month

I would really appreciate any help!

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I had a lisfranc repair that later had too much pain from arthritus as well as the bones did not quite set in the right place. So one year later I had the fusion done. As for the pain, I personally thought the fusion was less over all pain than the first procedure. Now that could be because the first time you do any injury seems to hurt....

It has now been two years since my fusion and I am so glad I had it done. I am 43 now and I will have a better qualitly of life with this foot than one that always hurt from arthitus. There will be an adjustment period with the fused foot when you start walking on it, but that only lasts a month or two. Even after 2 years I have no problems with my other joints in that foot. I am not sure why your doctor says that in time other joints in your foot would need fused?
Good luck.
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Thanks so much for that, it is good to know that you have had such a success after your fusion. Are you still able to do the things you did before, like driving and walking as far as you want etc?
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I went to 3 surgeons before mid foot fusion and never heard about future
fusions needing to be done.

Had my fusion, 1 screw, and a bunionectomy done 12/22/08. The pain was not so bad after wards.

Mentally, the non-weight bearing is the worst part. 3 more weeks of that to go. Get lots of help around your home.

I had a lot of arithritic pain in the joint before so I'm glad to have it done.

Hope it all goes well for you.
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Thank you for your reply, it does really help to hear from you considering you are going through it too. Ive been to loads of surgeons too, i have realised how badly diagnosed and treated lisfranc injuries and the after effects really are here in the UK.
I hope the next few weeks go quickly for you, it must be really hard.
Thanks so much for the advice!
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For the most part I will have to answer this with a "Yes". The foot will take some training to get use to walking longer distances. However over time you can get use to it. Just take everything slowly and as time goes on I am sure you will be happy you had a fusion done. It will never be 100% like your foot was prior to this teriible injury, but I believe fusion was about the best result I could have recieved to give me the best outcome.
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For the most part I will have to answer this with a "Yes". The foot will take some training to get use to walking longer distances. However over time you can get use to it. Just take everything slowly and as time goes on I am sure you will be happy you had a fusion done. It will never be 100% like your foot was prior to this teriible injury, but I believe fusion was about the best result I could have recieved to give me the best outcome.



So are you pain free when walking now? I can't even remember what that is like! Do you drive at all or do any sports?
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I had a midfoot fusion done on a misdiagnosed lisfranc two years ago. The recovery was long but well worth it in the long run. The pain is much improved. I did have the plate and all but one screw and a wire taken out about a year ago because of irritation. I was told beforehand that that was a possibility due to my age ( I was 20) and activity level. I will be honest as far as your concern about future fusions - the last x rays that were taken showed arthritic changes in the joints next to the fusion site and my doctor was not surprised, so I think that this is an occasional complication. Even with the new arthritis the pain is so much better and I went back to my regular sports - so I think it is the lesser of the two evils. Good Luck
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Thanks Pheobe7. So do you suffer with your new arthritus? Do you think that will need to be fused eventually? It sounds like you are quite active these days which is encouraging! I am worried about how much sport i will be able to do and also if i will be able to drive
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Depending on what sports you do I would say you could return to most sports after a good recovery and slowly building up to a level you where at prior to this injury. I was into weight lifting for about 7 years before my accident/injury and I would say about 6 months after my foot fusion I was starting back into weight lifting again. Over a few months things were just about back to where I left off prior to the accident. The only weight lifting exercise I could not really do well anymore where exercises for the calf muscle. Driving a car is not a problem at all.
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I waited over a year to have fusion surgery. Had a reconstruction and tendon repair Feb 2008. After every day in pain and as each day passed it was more and more dificult to walk. I finally had the fusion surgery on Dec 31 2008. I woke up and the first time in a year and a half, I had no pain. Everybody in the hospital kept wanting me to hit the pci pump. I did not need it. I am three weeks from surgery now and have no pain still. The only thing getting in my way is this cast. I am already putting some weight on it and still no pain. If any body is contemplating this surgery, make sure you have someone at home that can help you. It is hard to get around and simple things are harder. Remember to keep your foot above your hip for the first two weeks. This really kept the swelling down. I found that the bed with a wedge pillow or the recliner were the best for comfort. two more weeks in this cast and then maybe into a walking cast.
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rzoo, sounds like the surgery was a good idea for you, at least so far it does, that is great news for you. It would be great if you could update the board on how you get on throughout your recovery, i hope it continues to go well!
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Hi all,

It's good to hear some positive stories from people who have had fusions. I had my foot crushed in a car accident a year and a half ago. At the time they decided that my fracture was boarderline, so we decided on non operative. I didn't weight bear for 3 months and slowly went back to dance over 6 months. After that my foot started to hurt when I walked, or even stood for more than 20min. So we did scans and the MRI picked up arthritis. Between the middle and inner cunieforms of my foot. Fusion of that joint was suggested to stop the pain. However I was warned with my level of activity that I would probably get arthritis in the neighbouring joints. As far as I was concerned it was worth the surgery to get my life back. I did a sit down job for a year because I was never good enough to go back to my profession as a lighting technician. And my dancing was limited. I will keep everyone posted and I'd love to hear how everyone else is recovering. Good luck everyone.
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I had a midfoot fusion done 10 days ago. I'm already glad I had it done. I was in so much pain before the surgery, I wasn't able to sleep through the night. Now I'm almost off all pain meds (I only need Tylenol/Ibuprofen). My 3rd & 4th toes were curling under before and they've already straightened out.
I had a "Pain pump" (basically a nerve block like an epidural behind the knee) for the first 3 days and it helped a lot. I was really nervous about the pain ahead of time and this was might less than I expected.
I have a few recommendations. First, keep it elevated at all times (it's hard to sleep with your foot propped up, but do it anyway). Second, they tell you to ice it, but it's difficult because it's wrapped in bandages, so instead I iced the lower calf so that blod going to/from the foot was colder and it really helped prevent swelling. Third, if your insurance will cover it, request a "knee walker". It's like a scooter the kids use, only with an elevated, padded platform to rest your knee/shin on while you walk. It is SO much easier and more comfortable than crutches.
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Hi all. I just had my midfoot fused on Friday. I'm female, 25. Here is my story.

I injured my foot in July 08 in an auto accident and it was repaired two weeks later. I had a lot of injuries and surgeries from the crash but the lisfranc repair was by far the worst pain post-op. I had six pins inserted. Once I was walking again 3 months later it felt ok, not great, but just ok. It slowly got better as long as I wore VERY sturdy and padded shoes (I wore good-quality hiking boots). I never wore anything but hiking boots for a year. I could hike up to 6 miles and could not rock climb or run. I would be in a lot of pain after the 6 miles. My injury was complicated by damage to my achilles tendon which resulted in a tight achilles and therefore more pressure than normal on my midfoot. The culmination of all the injury recovery was hiking a mountain in Latin America in June of 09, on the 1-year anniversary of my crash.

After July 09 my foot got worse. The pain of doing everyday activities, even in the hiking boots, steadily increased. I was always in low-level pain that increased with activity and though the pain wasn't crippling it was constant, gnawing, soul-deflating pain. I started seeing doctors in Aug 09 and saw 4 foot/ankle ortho specialists. I had a CT scan showing severe arthritis and pain that increased with every passing day. The first two drs recommended fixing the tight achilles and doing nothing about the foot, though one recommended arthritis medication, saying surgery was a last resort. The third dr I loved but insurance wouldn't allow me to see him. Instead I saw his partner who accepted my insurance and liked him even more. Together they recommended fusion of the first three midfoot joints (the easy ones) and inserting bone graft/cadaver tendon into the 4th and 5th that would allow movement but fix the pain. At the same time I would have an achilles release and a bunion correction. The dr was a little hesitant about the 4th and 5th joint surgery because he said if those joints are just a little achey the surgery will only leave them a little achey. I was in greater pain than that however.

So, end of Oct 09 I finally had the surgery and I've been very surprised at how little pain I've had. I had a nerve block for the first 3 days and spent the night in the hospital and other than that I've been keeping the foot up. I had 4 screws, a plate with another 4 screws, and two pins inserted. The dr said he was surprised when he opened up my foot and said I had obviously been dealing with a lot of pain by the look of the arthritis in the joints.

Overall, I think fusion is going to be great for me. Even if I don't have a perfect foot, I'm looking forward to one I can live with. I'm very active and I plan to remain that way. I also recommend the knee scooter. As someone who, in the span of 18 months has been/will be non wight bearing for 6 of them, the knee scooter is the best thing there is for your mobility!

I'll answer questions as best I can, though I confess to being a scientist but not knowing all my medical details (amount of separation in the original injury, names of the foot bones, etc). Good luck to everyone out there dealing with this and please keep fusion as an option if you are living with pain after this injury. I'll let you know how mine goes. Stay positive!
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