Cheilectomy of the 1st MTP joint
Why do you need surgery?
Before being offered surgery, you should have tried other treatment in the form of wide-box shoe-wear, padding the swelling and stiff forefoot insoles.
This operation is offered to you if you continue to have symptoms despite trying the above measures and after you have been examined and counselled.
What does the operation involve?
The operation is done as a day case but come prepared in case you need to stay overnight. The operation is done under a general anaesthetic and a nerve block (which means numbing the nerves of the foot).
The operation involves an incision over the base of the big toe joint. The extra bump of bone on the top of the big toe is trimmed to free the joint and prevent the two sides of the joint rubbing against each other during walking.
Your post-operative period:
- You will have a bandage on your foot.
- You will go home with a surgical sandal on your foot.
- You must keep your foot raised for the first one – two weeks and if necessary afterwards.
- You can put your full weight on your foot when you are comfortable.
- Exercise your big toe as you can to regain joint movement.
- Use crutches if needed.
- The swelling may last for a few months going on and off and finally fading away.
- At two weeks, the dressing is reduced and stitches are removed.
- At six – eight weeks you have a follow-up for x-rays.
- Back into wide fitting shoes at two – six weeks.
- Off work for about two depending on your job.
- No driving for about four weeks.
What are the possible complications?
- Ongoing pain
- Need for further fusion surgery
- Sensitive or painful scar
- Big toe permanent numbness
- Joint stiffness
- Clots in the leg (DVT)
- Clots in the lung (PE)
- Chronic Regional Pain Syndrome
Smoking, diabetes, rheumatoid arthritis or being on steroids or blood-thinning medication increases possible risks significantly.
For more information on other operations for the arthritis of the big toe follow the links below.
For information on Big Toe Joint Replacement click here.
For information on Big Toe Joint Fusion click here.