Author: Foot Doc
Date: 8/22/2007 12:33 am PDT
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DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND 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 ADMONISHED TO READ NO FURTHER.
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I think that we have a serious failure to communicate here. So much of any opinion must be based on a complete understanding of the status quo, and you simply have not made that clear in terms that are unmistakenly evident to other than yourself. As an example, I had assumed that, as you mentioned the DIP joint, you were speaking of one of the four lesser toes, as the great toe does not have a DIP joint, just a single inter-phalangeal joint distal to the metarso-phalangeal joint. Lesser toes have both a proximal and distal inter-phalangeal joint distal to the metatarso-phalangeal joint. It now seems more likely, although you still have not definitively stated it, that you are speaking of the great toe, as you mention keeping that one stiff and straight. But am I still uncertain as to whether you have a flexion or extension deformity, though it would seem more likely from what you have offered that it is an flexion deformity, as you state that you can raise your big toe but cannot bend it, I would assume in flexion. But that is not consistent with having a bump on the bottom of the toe. So you can see my problem in attempt to picture what you are trying to relate. I would assume from what I can make of your description that you had a compression fracture near the base of the distal phalanx which either destroyed or severely messed up the inter-phalangeal joint. It also seems evident that you did not have professional care at the time of the fracture or that the professional care rendered did not appropriately address the problem. At this point any decision would have to be made with knowledge of the current status of the joint structures and the extensor and flexor tendons. I'm sorry, but there are simply too many loose ends and unknowns for me to really give you anything approaching a meaningful suggestion. |
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