Great Toe Cheilectomy
Surgery is performed as a day case under general anesthetic. The procedure takes 30 minutes
An 8cm incision is made on the inner side of the foot over the base of the great toe. The joint is inspected, and the extra bone is removed to allow improved movement. The skin is stitched, and a wool and crepe bandage applied.
All surgery carries potential risks. The risks are minimized by having the surgery meticulously performed by an expert in foot and ankle surgery. Risks include
- Pain, swelling, and bruising - will occur to some degree following all foot and ankle surgery
- Infection - approximately 2% in our unit .
- Blood clots (thrombosis) - treatment to reduce this risk will be provided if required
- Numbness - usually improves over time
- Stiffness - this improves over time and helped by physiotherapy
- Scar sensitivity - can be improved with scar massage
- Incomplete improvement - occasionally symptoms will be improved but remain present to a small degree. In 10% of patients, the symptoms remain or progress, and fusion surgery has to be considered.
Discharge advice following a Cheilectomy
Your foot has been dressed in a wool and crepe bandage. This dressing should not be changed until you are seen at your first follow- up appointment 2 weeks following surgery. The dressing must be kept clean and dry.
It is very important that you rest as much as possible and keep your foot elevated for the first 48 hours after surgery. Try to avoid letting it hang down when sitting as this will lead to swelling and pain. This is most apparent within the first 2 weeks but swelling may occur for up to 6 months after surgery, especially after sitting or standing for long periods. In bed, put the foot on a pillow.
You will receive a prescription for pain medication on discharge. Pain is often due to swelling, and this is eased by rest and elevation of the foot.
A special shoe has been supplied for you to wear over your dressings which should be worn during the day for 2 weeks. A physiotherapist will show you how to use crutches and apply the shoe. You may walk on the foot however it is comfortable but initially this will probably be by taking the weight through the heel. It is not necessary to wear this shoe in bed.
You will be seen approximately 2 weeks following surgery when the dressings and sutures will be removed. The foot is often slightly swollen at this stage and so a comfortable pair of loose-fitting shoes or trainers will need to be worn and should be brought to the out-patient appointment. I will see you again after 6 weeks.
You should not drive a car for 2 weeks following surgery. After this you should start driving gradually, to check that you are comfortable. It normally takes a few days to feel confident.
If you have an office-based job, then it may be possible for you to return after 2 weeks. If you have a more physical job, then it may take 4-6 weeks.
It often takes 6 months for all swelling to resolve following cheilectomy surgery, and minor swelling late in the day is not unusual and should not be a cause for concern.