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.


Your follow-up

  • 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
  • Infection
  • 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.

Patient Testimonies

Dear Mr Shalaby, Thank you for bringing my foot back to what it was, and for inspiring so many of my artworks. I wish you all the best in the future, and I hope you can continue to inspire hope in others, as you did in me.
Mr A J, 15 years old – Revision of EHL tendon repair
Dear Mr Shalaby Last year you operated on my ankle. It was badly broken and the joint was damaged. I was in doubt what the outcome of the Joint replacement would be. However I thought you would like to know that the operation was great success and I am walking now very well without a stick. I would like to thank you for all your professional care.  
Mr J G, 64 years old – Advanced post-traumatic Ankle Arthritis
Dear Mr Shalaby I cannot thank you enough for sorting out the severe deformities of my toes and the pain I was experiencing in the ball of the foot. The operation gave me my life back.  
Mrs E J, 55 years old – Rheumatoid Forefoot deformities
Dear Mr Shalaby My grateful thanks for your excellent professional care. My husband and I are very impressed with all the care and of course the results. Thank you.  
Mrs M M, 62 years old – Severe flat foot deformity
Dear Mr Shalaby Just a brief word to thank you for the excellent job you did on my ankle. After suffering years with my ankle pain, I can now say I have had no pain since the day of the operation and my overall walking ability has improved significantly.  
Mrs M G, 58 years old – Ankle fusion for congenital Dysplastic Ankle
Dear Mr Shalaby After the ankle ligament surgery, you performed I am back to all the sports I wanted to do and I can finally trust my ankle again. I am also writing to tell you that I have just manged to climb Mount Kilimanjaro. I greatly appreciate you help.  
Mr J A, 34 years old – Lateral ligament repair for Ankle Instability
Dear Mr Shalaby Just to let you know that last week I completed the 97-mile West Highland Way Walk with a group of friends. So again, many many thanks.
Mrs S M, 30 years old – Bilateral Bunion Correction