It is a day-case procedure. The operation is done under a general anaesthesia and an added local anaesthetic injection in the foot to numb it for after surgery. The operation itself involves a 2 cm incision on the top of the foot just between the toes over the painful neuroma. The procedure then involves carefully removing the neuroma from between the toes. 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 and given an out-patient 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 when it has healed.
Your physiotherapist will guide you through the stages of rehabilitation including toe mobilisation exercises, 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 4-6 weeks. Click here to read DVLA guidance.
This is very individual and job-dependent. Below is a guide:
Excellent pain relief once the wound has healed, which can take 2-4 weeks. Good level of activity and sports by 3 months. It will take up to 6 months to be fully recovered. It is an operation with good patient satisfaction in up to 90% of cases. Mild swelling can persist in the foot for up to a year. Isolated toe numbness will likely persist as the nerve has been removed but is rarely troublesome.
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%.
Unfortunately symptoms can persist in some patients (estimated 10-30%). If this is the case then further treatment can be discussed. This can involve repeated injections or even further surgery that may only be successful in 60-70%.
In the early post-operative phase, swelling and stiffness is quite common but generally improves with time. You can reduce the stiffness by performing regular exercises.
Symptomatic clot formation in the leg is unusual after foot 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.
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.