It is a day-case procedure. The operation is done under a general anaesthesia and an added injection in the foot to numb it for after surgery. The operation will involve 1 incision on the top of your big toe about 4cm long. The procedure involves removing the painful damaged joint and the bumps of bone around the joint. The metatarsal bone is then attached to the phalanx bone and held firmly with a metal screw and plate that stay in long term. Dissolvable skin stitches are used.
Your foot will be bandaged, numb and pain free. You will see a physiotherapist who will advise on mobility in a padded stiff shoe supplied. You will be discharged only when comfortable with an appointment and pain-killers as required.
In the first 2 weeks keep the bandaging totally dry. You may shower with a waterproof cover over the foot. After 2 weeks you can only shower if the wound is healed but gently dab the wound dry.
Once out of bandaging, do not pull at scabs but let them fall away naturally. If your wound becomes red, swollen or sore you need to see your Consultant to ensure there is no infection present. Your physiotherapist may advise on wound massage.
Your physiotherapist will guide you through the stages of rehabilitation including gait re-education, swelling reduction and reducing muscle tightness. It is important to adhere to advice given.
DVLA states it is the responsibility of the driver to ensure they are always in control of the vehicle. A good guide is if you can stamp down hard with the foot to stop the car in an emergency stop. This will take at least 6 weeks. Click here to read DVLA guidance.
This is very individual and job-dependent. Below is a guide:
Excellent pain relief is noticed quite quickly which improves until the toe has fused, which can take 3 months. Good level of activity and sports is expected by 6 months. It will take 12 months to be fully recovered. It is a very successful operation with excellent outcomes in over 90%. Mild swelling can persist in the foot for up to a year.
Any operation carries a risk. Below is a guide to some risks potentially encountered. It is the surgeons duty to fully inform you of possible risks. Mr Roche will ensure this is always done so patients can make safe and informed choices about their operation.
If this happens, it is usually simply treated with antibiotics. Significant consequences from infection are very rare but can be dealt with. Risk is around 1%.
Nerves that supply sensation to the skin are near the incision site. Damage is rare but if your toe stays numb after surgery, the nerve may be bruised. If so it usually recovers. Risk is around 5%.
This means the bones fail to biologically fuse. Occasionally it can be “painless” and intervention may not be needed. If painful, then treatment options will be discussed, including further surgery. Risk is around 5-10%.
Sometimes the metal can be prominent and once the bones have fused, usually after 6 months the metal can easily be removed with a small day-case operation.
Symptomatic clot formation in the leg is unusual after foot and ankle surgery (<3%). Whether treatment to prevent clot is needed can be discussed with your surgeon. There is no consensus amongst UK Orthopaedic surgeons as to whether preventative medicine is needed.
Certain things may delay or even prevent the bones from fusing together. You must try to avoid them. This includes:
This document is only meant to be a guideline to help you understand your treatment and what to expect. Every person is different and your rehabilitation may be quicker and slower. This will be advised and guided by your doctor and physiotherapist.