Notre Dame Linebacker, Prince Shembo, is out for the spring season as he recovers from foot surgery.
Shembo was suffering from turf toe (a sprain to the ligaments surrounding the big toe). It is a common injury in athletes. The surgery consisted of inserting a screw into his toe.
“He’s in a cast right now,” Coach Brian Kelly said of Shembo. “I think his prognosis is probably six weeks. They had to put a screw in there. I think, generally speaking, when you get into the bone it’s a six-week procedure.”
MN orthopedic surgeon, Dr. Lance Silverman, believes that these reports are off base, and perhaps even that Shembo’s injury was mis-diagnosed and mis-treated.
Dr. Silverman Comments
I have discussed in previous posts that chronic Turf Toe in the popular news may be arthritis of the great toe otherwise known as Hallux Rigidus (aka a stiff big toe).
If Prince Shembo had treatment for true Turf Toe, he would have undergone a rebuilding procedure of the plantar plate. It is unusual to use a screw in this procedure. If he had Hallux Rigidus he may have undergone a great toe decompression in which the surgeon takes a piece of bone of the great toe to theoretically decrease joint pressure.
In my opinion, this type of surgery is never a good choice. It changes the way the foot works and increases pressure under the ball of the foot. The other choice that uses a screw is a fusion of the great toe joint. I highly doubt that a college athlete had this procedure as it permanently blocks foot motion and is usually used as a last resort.
Instead of performing a bony decompression, I would have performed an orthopedic surgery known as a chilectomy and soft tissue arthroplasty. This procedure resurfaces the great toe joint with the body’s own tissues. It keeps all the attachments and improves the damaged toe range of motion. This procedure works wonders for athletes who need to push off the great toe as it eliminates the pain and keeps the function of the toe. Women continue to be able to wear heels after this procedure (unlike with a fusion). Both physicians and patients rate the success of this surgery very high.
Lance Silverman, MD
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