Question
Dr. Katz,

My husband suffered a crush injury to his right foot. His foot was run over by an 8600 pound forklift.  The forklift stopped on his foot for s short time. This accident happened almost 3 years ago.  Since that time he has had chronic intractable pain.  He has had 3 surgeries, the first an OATS procedure, then a fusion of joint in the great toe and finally a full fusion of the great toe.  None of these have lessened the pain.  Also, he is still unable to be on his feet more than 3 1/2 to 4 hours at a time.  He continues to have stinging and sharp shooting pain that sometimes cause him to fall. He also complains of the feeling of bugs crawling on his foot. He continues to have swelling and ices his foot daily.  He is not able to put any pressure on the ball of his foot. He has recently had an IME with a Orthopaedic Surgeon who suggested yet another surgery which would include lengthening the calf muscle, releasing the tendons in 3 toes and shortening the bone in those 3 toes and possible repositioning of the fused great toe.  Are you familiar with this surgery?  Does this sound appropriate for this type of injury after the first three surgeries or is he going to be faced with this chronic pain from now on?  Your response is greatly appreciated.

Answer
Hi Diane,

This is a very complex injury especially after multiple surgeries.  I would consider cryosurgery to kill the nerves in the foot.  See my site below.  Before more bone surgery, I would look at having an AFO type brace made for the foot.  He could also consider a spinal cord stimulator to block the pain sensation.  Going through too many surgeries can be just as bad as the injury.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
http://www.thetampapodiatrist.com
http://www.tampacryosurgery.com
http://katzpodiatristtampa.blogspot.com
http://painfoot.blogspot.com
http://twitter.com/TampaPodiatrist
http://www.notoenailfungus.com
http://www.vibranttampatoenails.com

DISCLAIMER:
This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem.  It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice.  Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan.  No doctor/patient relationship is created or established here and may not be inferred through answers on this site.  The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site.  The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further.