Hi Dr. Silverberg,In July 2010 I had a similar iunrjy to the patient you describe above. A fall off my bike broke the distal phalanx of my right great toe. Unfortunately, the fracture entered my interphalangeal joint as well however the fracture was not displaced. I got xrays and saw a DPM. No surgery was recommended. He put me in a hard soled boot for six weeks and told me not to run for 10 weeks. I’m 32, very active (big runner and cyclist) and was very concerned that this would limit my activities. I was told of the potential for osteoarthrits and perhaps fusion down the road.Today the toe is still painful. It’s a constant bother even while walking a few blocks. I have regained complete control and range of motion of the toe, however it feels like there is a bump under the toe- it doesn’t lay flat comfortably. I can still run and bike, but do so with constant discomfort. The joint space shows some arthritic change on xray btw. A cortisone shot eased the pain for a couple months, but now it hurts again. My DPM tells me nothing more can be done and suggests continued cortisone injections. I have no interest in a fusion at my age. Is there really nothing else that modern medicine has to offer? I’ve been reading up on stem cell injections lately- any thoughts on that as an alternative treatment? Do you have any other thoughts on what might be done? Thanks very much for the help.
Hi Dr. Silverberg,In July 2010 I had a similar iunrjy to the patient you describe above. A fall off my bike broke the distal phalanx of my right great toe. Unfortunately, the fracture entered my interphalangeal joint as well however the fracture was not displaced. I got xrays and saw a DPM. No surgery was recommended. He put me in a hard soled boot for six weeks and told me not to run for 10 weeks. I’m 32, very active (big runner and cyclist) and was very concerned that this would limit my activities. I was told of the potential for osteoarthrits and perhaps fusion down the road.Today the toe is still painful. It’s a constant bother even while walking a few blocks. I have regained complete control and range of motion of the toe, however it feels like there is a bump under the toe- it doesn’t lay flat comfortably. I can still run and bike, but do so with constant discomfort. The joint space shows some arthritic change on xray btw. A cortisone shot eased the pain for a couple months, but now it hurts again. My DPM tells me nothing more can be done and suggests continued cortisone injections. I have no interest in a fusion at my age. Is there really nothing else that modern medicine has to offer? I’ve been reading up on stem cell injections lately- any thoughts on that as an alternative treatment? Do you have any other thoughts on what might be done? Thanks very much for the help.