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[RedwoodsMama]

 Ok, this is not a pleo question, not a botic question and not even a cat question. I fell off my front porch/ stairs late Thursday night, after comming back from feeding the five outside stray cats that I have been taking care of for years. The steps are between three and four feet high, and very narrow so they are allways very diffiuclt to manuever on in the first place. I fell face forward, but luckily put my hands down so not as to hit my head or already injured back, The problem is that I have had multiple foot injureis and surgeries in the past ten years with my right foot being the worst.

               In 2001 while On my bike I was hit by a truck and suffered what is called a JOnes Fracture, a comminuated fracture of the fifthh Metatarsal,( little toe and side of foot at the outside part of foot) It took seven months to heal and because I was on crutches and in a cast, walking boot for months and months, I lost what is called Plantar flexion, I can push my foot backward or towards me but it can not push down, towards the floor anymore. It is contracted at the ankle. AFter this I also had a bunionectomy that failed. The Dr. tried doing it again and it was over corrected resulting in what is termed, Hallux Varus, meaning the big toe points towards the other foot, instead of towards the other toes. Of course this makes wearing shoes impossible and I had a second opinon with two other dr.s and went to another dr. who tried to salvage my foot, but it also failed, The last result was a fusion of the big toe, ( I have a metal plate with five or six screws implanted). I also had both sesmoids removed because of severe degeneration and they were causing severe pain.               

               When the big toe is FUSED, it can no longer bend, and this can cause lots of problems, I mention all this history because it has to do with my current problem. On Thursday when I fell down the steps, it was this foot that was injured and because of this big toe that can not bend that I was injured.It caused severe immediate pain, swelling and discoloration. I crawled to bed and called the dr. in the morning, not much you can do at 11:00 p.m at night...The podiatrist I see could not see me because of his busy schedule but wanted me to go get an xray and see either my family dr. or go to urgent care and then follow up with him this Wed. (19th) I went to my regular dr. and she examined me quickly and sent me for Xray. I had no sooner left Xray and because of the questions the X ray tech was asking, ( do you live in town, are you going to see the dr. etc, etc.) I knew my suspicion that something was wrong was right. My podiatrist called within half and hour of me getting home to tell me he and the family dr. had seen the Xray and I had a very severe dislocation of the first metarsal,( big toe) and it needed to be corrected. He said because of the lateness in the day that I would have to wait till Monday to see him, He said he would attempt to put it back in postion after numbing the area and giveing me some sedation, but that it was not even connected to the joint anymore and if he could not put it back in postion, that he woujld have to take me to the operating room to repair it.Luckily the plate and screws had helped prevent the bone from breaking but other things tore away.

               I have not been able to find out a lot of information on the internet about dislocations of the big toe, other than one scary looking video. I am wondering is there any of the members here on the forums that have dealt with a dislocated toe before and what happened? I know it can be quite painful, dispite the "numbing" medicine and wonder what to expect? How long does it take to try and put the bone, back into place? If I had somewhere else to ask, I would but I know you guys more than anyone else and feel comfortalbe asking.I thought about posting photos but thought I would just ask to see if someone here has been through this before. You would not think having a dislocated bone would hurt so much, but it hurts as much as my foot did when broken, Anyway, thanks for reading the post and if anyone can share any thoughts, Monday I also have a back procedure to go through for a couple of hours, so it is a good day to be "flat  out" for awhiile.

                                                RWM     

[MariaOcean]

I just searched on Google and think this might help you
http://www.thetoedoctor.com/dislocated-toe/
Get well sone

[Lunamione7]

Oh dear RWM that sounds horrible  I am so sorry to hear about it and also sorry because I have no useful words of advice as it has never happened to me or anyone I know.
I hope that it is able to be fixed without the surgery and that it is not too painfull for you. Very best of wishes.

[gucci_boi7782]

Oh RWM, this is terrible. I hate to hear any of this. Never having to experience this, I suppose you'll just have to take your meds, and wait on the doctor. I know hot tea with honey, a cup of hot soup and a bit of love from your pets, spouse, or Pleos always helps!! Sorry to not be too helpful.

Best of luck, though!

[RedwoodsMama]

Thanks for the feedback guys, I did lots of googling and Maria , thank you very much for the site you suggested, It gave me lots of reading and something to think about while I wait to see what happens tommrow. I just don't look forward to having someone yank on my toe in the postion that duplicates the dislocation, esp since I have a plate and pins in my foot, it does not or can not bend anyway. :(Well, I can load up on pain meds, warm blankest and hot tea, cocao or hugs from my cats till then. If I can only get some good photos of my Pleos doing surgery on my foot, now that should be good for something?   RWM

[kat]

Hope you feel better soon RWM.  It must be very painful and I do hope they can fix it for you fast.   

[Talon]

Oh my, Redwoods that sounds terrible! I've never had anything like that. I guess you could say I've been gently used as far as my body goes. I fractured my skull as a toddler after falling off a couch onto a concrete floor, broke my right rist at the age of nine after falling from a top bunk, tore my ACL while performing the running long Jump in junior high, and ended up with a hairline fracture in my left hip in high school on a sheet of ice. No dislocations, just a few broken bones and lots of emotional and verbal abuse.
Talon

[RedwoodsMama]

Hi Guys, thanks for the words of encouragement. I was at my first dr. appt, for my back at 9;00 a.m and after sedation and IV, woke up and left by 11:30. Next appt was for my dislocated big toe, or first metatarsal, it was at 1:00 pm. I got in to see the dr. pretty quick and after showing me the X ray and how bad my dislocation was, ( very visible on side view) and then seeing that there was no tendons or ligaments left, they had completly ruptered when falling, the dr. explained what he would do. He first sprayed some cold stuff on my ankle and foot and after about five minutes the torture began.. He inserted 3 very long needles into the ankle, side of my big toe and under my big toe. It drew blood and hurt almost as bad as the initial fall, except this went away, the constant pain in my toe, foot has not. After about 15 minutes of letting it work, he came back to work his "magic" , what is called 'NREDUCING" the dislocation or tyring to put it back in position, the bone that is. I just lay back and closed my eyes, I felt tugging but did not realy feel any pain.

            He thought he got it repostioned, but told me because it was such a severe dislocation and there are no ligaments or tendons left, they are completly torn away on either side, that the big toe is very prone to dislocation over and over, I have to be really cautious about everything I do, cause the littlest movement will put the bone out of postion again.I then was fitted for a large boot that goes just below my knee. I am suppoesed to keep the boot on 24 hrs a day for 4 weeks at least to try and let the bone heal and since the tendons and ligaments are no longer attached, we have to wait for scar tissue to build up and attach itself, The metal plate and five screw in my big toe from it being fused are right at the very edge, My bruise is in the shape of the plate which is funny. The toe looks almost like it did to start with before resetting, so I am not sure it has stayed in postion. I took photos and will post some tommrow. I have to go to the Radiology department at the hospital in the morning and get a repeat Xray from Friday, to see if  it did get in the proper postion. I am getting copies for myself so I will know what it looks like as well. I am supposed to wear this darn boot even when sleeping, only taking it off to bathe, it weighs a DARN TON, and with a throbbing hurt toe and foot that is swollen, it hurts already wearing this thing. Everytime I move my foot in bed with this boot on I am going to kick my hubby in the head or a cat, so I think wearing it in bed is too much............What would you guys do if you were told to wear a heavy boot on your foot 24/7 for at least the next 30 days!?   I also got some good pain meds, as my back meds do not work for my foot pain so hopefully I can get a good nights sleep. In the morning I will find out if the bone stayed in positon or not, I have a feeling it is not...............am not looking forward to more needles........ :cat-hug:RWM and the l(aughing at me wearing a boot, ) P;DPleos of the Redwoods. ( Only Argyle and Chester are not laughing....just wait till Christmas guys.....)

[Lunamione7]

 

Oh my goodness I was almost sick when I read about the three needles in the foot and the blood, what a horrible thing to have happen. And you were good enough to just sit there and take it, I would have cried and caused a huge fuss. They would have had to knock me out and tie me down.

I would probably wear the boot for the rest of my life if they told me any little movement would cause it to dislocate agian, if I had a husband or a cat they would just have to put up with being kicked in the head all the time because I'd be frightened of risking the three needles and blood again 

I think you should get a medal of bravery personally. 

[Denver2]

Hello, RWM, I read what happened to you and I'm so sorry. Two years ago, because of a trivial fall I broke my ankle and I still have problems. I wish you a speedy recovery with affection
Denver2

[Crewella]

Wow, that sounds horrible, RWM! 

Really hope it gets better soon, and you mamange to keep off it and rest it.     

[kat]

That does sound horrible    I agree with Lunamione    If the doctors say where the boot 24/7 then wear it   If you don't then you may end up in plaster with no choice but to wear it and have to go through re locating your toe again - maybe even a few times before they resort to drastic measures.  I'm sure you hubby and cats will forgive you and still love you.    
Fingers crossed your Xrays look much better the next time around   I'm guessing it is still going to hurt quite a bit even now after they (hopefully) put the toe back in place, because of the tendons and other tissue being damaged and torn so be brave and know we are all here for you anytime you feel up to it

Feel better soon     

[RedwoodsMama]

 Thanks for all the help and well wishes everyone, I got the full Xray report after having my repeat Xray , and found out more infor. First of all, Dr.s do not divulge everything to you, so I was surprised to find out a couple of things, I am a definite promoter in being your own health advocate which means getting copies of your own records. Also if you have lots of tests, MRIs, etc, get copies of your reports, it is your rights.

          As you know, I fell off the front steps, porch late at night on the 13th, about 11;00 p.m, Here is the original report taken Dec. 14th, before I saw the dr.

 Finding; there is a fraction -dislocation of the distal phalanx of the great toe. The distal phalanx has been dislocated dorsally. Small medial fracture fragment is seen. Solid fusion across the first MTP joint and dorsal plate and screws are noted.
          Impression: Fracture-dislocation of the distal phalanx of the great toe.
                              Status post instrumental fusion of the first metatarsalphalangeal joint.
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               Follow up Xray dated, Dec. 19th, 2012

         Findings compared to Xray of 12-14-2012
           The bone mineralization is diffusely diminished. The dislocated dital phalanx is now relocated., but there is clearly and oblique intra-articular fracture of the base of the distal phalanx of the first digit. The pt has had fusion of the first metatarsal  and proximal phalanx. A plate and traversing screws are noted. The fusion seems to be complete.
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          Impression: Relocated distal phalanx of the first digit, but there is clearrly and oblique intra-articular fracture of the base of the dital phalanx. There is no significent displacement of the fracture fragment.


            So even though the big toe has so far been re postioned, there remains a fracture at the base of the big toe, top part of the joint. The problem is that there are no joints are ligaments left, thus that is what Intra articular fractures are. Also it appears I have "soft bones", not the same as Osteroporous, but it does mean my bones are prone to fracture easily, and even more so now after this fracture. So I guess I will try to keep the boot on as much as possible to keep from dislocationg the toe again. Now we wait for scar tissue to form, Mly other problem is that intra articular fractures happen in the joint, ligament area and are prone to down the road cause arthritic pain and may require a fusion. I already have a fusio of the bottom two joint areas, so what is the likili hood of having the top of my big toe fused as well....? Ok, back to getting boot on.              RWM

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[Crewella]

Ouch!! 

Hope you feel bette soon, and it doesn't spoil your Christmas. 

[kat]

It does look very very sore.  Keep your chin up and try to have a merry Christmas anyway