Question
Hi Dr. Katz:

I am a 48 year old women with diabetes and Rheumatoid Arthritis. I was diagnosed positive for RA in 1993. Believe it or not it started in my left big toe. Since that time my feet have been deforming. I had surgery about a year ago to remove RA nodules from both of my feet 4 on the left and 3 on the right. On my left foot I formed an abscess back in March of 08 in the metatarsal area. I had it surgical cleaned out, however a small hole remains which drains occasionally. I experienced a tenderness on the left foot again to day and had a vast amount of drainage. My Podiatrist did culture it and put me on Keflex. He informed me that I need to have all of my metatarsal heads removed. That due to the RA I no longer have any padding in the area. Also my left big toe is no longer straight and curving toward the other toes. It is almost bent on an angle. Which will require surgery as well. My question to you is, how common of a surgery is having all of the heads removed. Will having all of my heads on my left foot removed, will it limit my actives after recovery? What is the usual recovery time for this type of operation? How much pain will I really experience? Any further information on this subject is greatly appreciated.

Answer
Hi Cherie,

having the metatarsals removed in severe cases of rheumatoid arthritis is fairly common.  This will relieve the pressure points from the ball of the foot.  You will have less pain and decreased risk of developing ulcers or infections.  You should actually be able to function better after the surgery has healed.  Healing time will likely be 3-4 weeks before using a shoe.  Pain levels are variable for each person.  Good luck.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com
www.cryosurgerypodiatrist.com


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