First MTP Joint Cheilectomy

What is a Cheilectomy?

For the more minor type of hallux rigidus (big toe arthritis), shaving of the bump of the bone on top of the metatarsal is sufficient, and this is referred to as a cheilectomy.

Type of anaesthesia

The operation will be undertaken under a general anaesthetic supplemented with an injection around the ankle to numb the foot (nerve block). The effect of this block will last for a few hours after surgery.

How long will the surgery take?

The surgery normally takes approximately 15 minutes.

Risks of surgery

Any orthopaedic surgery carries some inherent risks and it is the surgeons responsibility to fully inform you regarding the benefits and risks of this procedure. Mr Shariff will go through this in detail with you to help you make an informed decision.

This is a fairly routine procedure with risk of:

Infection

If this occurs it is usually a superficial infection around the wound site.It settles with a course of oral antibiotics. Deep infection is extremely rare. Overall risk is 1%.

Pins & needles or patch of numbness:

Small nerve branches which supply sensation to the skin may be bruised or cut when the skin incision is made. This may cause pins and needles or a patch of numbness around the scar or the top of the foot. This feeling generally resolves within a few weeks to a couple of months. Overall risk is 5%.

Recovery from surgery

What can I expect immediately after the surgery whilst in hospital?

When you wake up, it is normal to have numbness in the operated foot as the anaesthetic block will take a few hours to wear off. You will have a bulky dressing to your foot and a below knee back slab (which is half a plaster) applied. You will not be allowed to walk on the operated foot for atleast 6 weeks. The physiotherapists will make sure that you are safe on your feet before discharge and you will be provided crutches. You will also be given painkillers to take home. It is normal to experience moderate pain after surgery and you can keep this to a minimum by taking regular painkillers.

Specific recovery protocol:

Day 1 – 7

Ensure that you keep your foot elevated on pillows to help reduce swelling.

Foot wrapped in bulky bandage and surgical stiff sole shoe

Allowed to walk in a stiff sole shoe.

Ice, elevate, take pain medication

Expect numbness in foot 12-24 hours then moderate pain

Bloody drainage through bandage expected.

Do not change bandage.