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Forum Name: Bone trauma and fractures

Question: I cannot move my big toe and it's part numb.


 jasonmburns - Fri May 27, 2005 2:25 am

I was running barefoot up my stairs 1.5 months ago when I slipped and my toe slammed into the steps. Since it has swollen up and has lost feeling in part of it. I have also lost movement in it. I cannot bend it downward, but I can bend it upward with a little pain. It is very painfull. I need to work and can't afford days off, but it is very difficult and painfull to walk on. On the X-ray, it doesn't look broken. I have had three different sets of X-rays taken since this happened a month and a half ago. The doctors can't make any sense of it. They have ordered an MRI to be done next week. It hasn't healed at all in all this time. I am extremely worried about it. It feels rough and dry where the swelling has occured. The swelling is directly under my joint closest to the toe nail of my right big (great) toe. That is where the pain is coming from also. The numbness also starts right there and continues to be numb to the end of my toe and on the left side by my toe nail on top, but not on the right side. I have tried to bend this toe downward with my hand also, but it is stiff and doesn't want to bend. This causes pain and only moves it about 30-40 percent. What is wrong with it. Please help me. I want it to be normal again! Thank you.[/b]
 Theresa Jones, RN - Sat May 28, 2005 9:50 am

User avatar Hi jasonmburns,
It sounds like you may possibly have a fracture as well as a type of nerve compression. I would suggest an evaluation.
Sincerely,
Rntdj
 jasonmburns - Sat May 28, 2005 5:55 pm

Rntdj wrote:Hi jasonmburns,
It sounds like you may possibly have a fracture as well as a type of nerve compression. I would suggest an evaluation.
Sincerely,
Rntdj


Thank you for your help. It is really appreciated!

But I have been going to the orthapedic specialist every week for almost two months now and they haven't found anything. I have three different sets of X-rays at different angles, all taken on different dates, starting when the accident happened two months ago to just a week ago and none show a fracture. Also, where it is swelled up, that is where it starts to go numb. This is directly under the knuckle that is closest to the toe nail. I cannot bend it downward, and it's extremely sore. It is very difficult to walk on and I cannot put any weight on the toe. It is extremely weak if I try to bend it down using my toe muscles. Also, when I try to bend it down using my toe muscles, I can only get a little wiggle out of it, about a centimeter or two, but no real movement downward other than that. Do you have any other ideas what it could be? The upper tendon seems to have tightened up a great deal and pulling up on the toe a little, but it doesn't look raised as if I completely tore the lower tendon or anything. I have been bending the toe downward a little to stretch the upper tendon a little. Should I continue to do this? Should I tape it down at night when I sleep, so the lower tendon is not being stretched more to alow it to heal if it's ripped. Also, I am taking IBU 800 for pain and swelling, but swelling doesn't seem to be going down any. Thanks for all your help so far.
 Theresa Jones, RN - Mon May 30, 2005 7:48 am

User avatar Hi jasonmburns,
If stabalization wasn't already recommended by your physician I would not advise doing so. Out of curiosity is there any redness that accompanies your current symptoms?
Sincerely,
Rntdj
 jasonmburns - Mon May 30, 2005 11:08 pm

Not really any redness. Just swelled up and numb. Also cannot bend it downward very well. From the reading that I have done, it sounds to me like a stage 2 tendon tear of the tendon below my joint neerest my toe nail. What do you think? Thanks again.
 Theresa Jones, RN - Wed Jun 01, 2005 3:40 am

User avatar Hi jasonmburns,
I would still relate the pain you are having to one of two things, inflammation of one of the sesamoid bones in the toe or a type of nerve compression (tarsal tunnel syndrome). In my opinion since there seems to be no evidence of fracture etc. I would certainly consider the latter as it may also cause symptoms such as yours. I would certainly suggest that at your next visit that you discuss this with your physician.
Sincerely,
Rntdj
 jasonmburns - Thu Jun 02, 2005 5:42 pm

"I would certainly consider the latter as it may also cause symptoms such as yours."

Please clarify. I am not sure what you are trying to tell me. Do you think it is my tendon, or just a sesamoid and what does that mean to me? What is the usual fix for this?

Thank you very much.
 jasonmburns - Thu Jun 09, 2005 7:10 pm

Well, I had the MRI done, but it came up negative. I also asked about tarsle tunnel and he said absolutely not the case here. I was sent to a speciallist and he said that judging on the weakness of the toe, he thinks my tendon was completely ripped. He wants to remove the sesamoid bone and said he could maybe attach the tendon, but probably not because it's been so long that it has probably retracted. Does this sound correct to you? I don't want to loose function of my toe forever!!! Why can't they find it and attach it? Please help me! I am so stressed out about this.
 jasonmburns - Fri Jun 10, 2005 1:27 am

To add to the last post I just left above...

I was wondering how many tendons are on the bottom of the big toe. The reason I am wondering is because even though my bottom tendon that holds the sesamoid bone is supposedly broken, my toe is still not rising up in the air. (being pulled up by the upper one) and I can still wiggle it just a little with very little strength. Are there more than one tendon that could be holding my toe down, or is this doctor crazy and my tendon is still somewhat intact? I was also wondering just how this sesamoid bone is attached to the tendon, and if it is attached to the tendon still, wouldn't that bone be keeping the tendon from drawing back up into my foot, or would it just pull through the sesamoid bone? I am so confused. I need a human great toe anatomy lesson!

Maybe I should quit my job as an electronics technician/programmer and spend the rest of my life going to school to become a doctor. LOL JK But seriously, why in the world with as much as they make (doctors) and all the schooling they have, can't they figure this out? Where is our technology really at? My doc is trying to impress me with the fact he knows the scientific names of all my body parts, but I want to be impressed with a proper diagnosis and to see some technology put to use to fix a simple problem like a stubbed toe. C'mon, it's been how many months now and I am just where I started, maybe even worse since my tendon may have pulled up into my foot and now I may be stuck like this forever! If they cannot fix a tendon in a toe, can I trust them with a vital organ such as my heart? Guess at that point I wouldn't have much choice really anyway. Can you understand my frustration? I need some really professional advice! :?
 Dr. Wafaa Abdel-Hadi - Fri Jun 10, 2005 5:27 am

Dear Jason,

I haven't had time to read all your posts,Sorry...but it seems that you need a proper radiological assessment....even with a MRI....it'll show you the EXACT anatomy and defect inside....I know it sounds rediculous to do a MRI on a toe...but if they can't figure out what's going on,then they should do that since it's restricting your mobility and you're having pain.

If they failed to diagnose...then you should go to an expert in Hand/foot surgery ...not to any regular ortho doctor ...he should open it up and explore it with a small incision...that's why i advice you to go to a hand/foot ortho surgeon because he'd be knowing EXACTLY what he's doing and the effect of every incision on your toe's mobility after the operation.

I promise i will read all your posts when i have time.

Best regards,
 jasonmburns - Fri Jun 10, 2005 6:24 pm

I had the MRI done and it came back negative, but the foot doctor that I am seeing now says that the MRI could be wrong!?!?!? He said that judging by the strength in my toe, he thinks the tendon is completely gone and retracted. Is this enough for him to go on? Is it possible for the MRI to be wrong? I am confused.

Also, the doctor I am going to is a foot doctor. I don't know if that is the kind of doctor I should be seeing or not, but I have had many, many doctors now because one doctor kept refering me to another until I got this one. How do I find an expert in hand/foot surgery in my area?

I am kind of scared to have surgery also because I am scared of going under and also scared of feeling pain while they are performing the surgery and not being able to let them know while I am under. Are these fears that I am haveing reasonable? I have had a bit of an anxiety/panic disorder in the past that I thought I was over years ago, but this situation seems to be bringing it back to the surface. What do you suggest that I do to handle this fear and anxiety?

Thank you for a quick response and for you efforts! It will be remembered and is very much appreciated.
 jasonmburns - Sat Jun 11, 2005 3:24 am

Oh, just one more thing...

I am sorry to be posting so many replies, but this problem kind of consumes me right now since I can barely walk, cannot run or jump, and so on.

While playing with my toe, I realized that I still cannot physically bend my toe using my hand. While trying to bend it, I feel a catch, like bones catching and grinding, and it just will not bend down at that lower joint nearest my toenail. Even though the x-rays look good, could this be a mechanical problem with my joint or something, and not the tendon at all? But why all the swelling and numbness? I really hope this doctor that I am seeing is wrong and this isn't a tendon problem at all since the MRI said it was negative as well. I am trusting in God to help me with this one. It's really out of my hands. I know there is a doctor or nurse on this forum that can give me some sound advice. Like I said, this consumes me and I have to get past this one way or another. I really want to thank all of you for your advice! :) It's good to know there are still people out there who care about others! I was beginning to think all doctors were only motivated by the almighty dollar. Looks like I was wrong. LOL Thanks again. God bless you all. :wink:
 Dr. Wafaa Abdel-Hadi - Sat Jun 11, 2005 2:51 pm

Hello again, I understand your frustration ofcourse...!! well, MRI would be the best imaging technique to see what's going on in your toe.

I don't undertsnad why the doctor hasn't seen anything positive or that leads to a diagnosis. Well, may be there are a lot of adhesions and oedema(swelling)that are blocking the view?

You can search on google for orthopaedics doctors specialized in foot/hand surgery.....and since they can't figure out the exact defect by clinical examination and MRI...then the second choice would be explorational surgery to see the exact defect and probable repair.

Good luck,
 jasonmburns - Sun Jun 12, 2005 4:12 am

It was a very mild, simple injury. I just stubbed my toe, and not really that hard. Do tendons tear that easily? There shouldn't be anything that could block the view really, I wouldn't think. The test did come back negative. They didn't say anything about not being able to read it. Do you think that a sesamoid problem could cause this loss of movement? I am on my feet alot at work and was wondering if the lack of rest is keeping it from healing. But it has been months and I don't know how reasonable that is. Could an ultrasound help me to see where the swelling is coming from?

Thanks again,
 Dr. Wafaa Abdel-Hadi - Sun Jun 12, 2005 12:46 pm

Ultrasound is an option...although ,supposedly ,MRI has shown everything.
do you have Diabetes or have you checked yourself for it?

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