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- Big Toe (Hallux) 1st MTP Joint Fusion Surgery
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- Foot Fusion Surgery
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- Toe Fusion Surgery
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Toe Fusion Surgery (including big toe fusion)
Toe fusion surgery is carried out to straighten the joint(s) of the toe.
What does surgery involve?
Carried out while you are under a local or general anaesthetic, the toe is straightened and held in place with metal wire or a clip inside the toe. Surgery is usually carried out as a day case procedure.
You can help improve the outcome of surgery by attending a pre-assessment screening where you’ll have blood tests to check for levels of Vitamin D and swabs to rule out infection or other problems. You’ll also be weighed and have an opportunity to discuss your medical history. This is important so that any anaesthetics problems can be identified.
Please note: it’s important to stop smoking at least eight weeks before your procedure; this is because smoking can affect the body’s ability to heal and causes health problems including an increased risk of blood clots forming in the lungs (pulmonary embolism) or calf (deep vein thrombosis).
What happens after surgery?
Your foot will be numb and pain-free (from a local anaesthetic injection around the affected area). A member of our physiotherapy team will help you to walk in a specially designed padded shoe, and will give you a tailored programme of exercises to follow over the next few weeks. You may be advised to take painkillers and a follow-up appointment will be arranged with Mr Heidari.
What can I do to speed up my recovery?
Raising your foot above the level of your heart and keeping weight off the foot as much as possible during the first few days can help with recovery. Make sure you follow any advice about keeping the wound clean and dry, and carry out the exercises advised by your physiotherapist as these will help you to return to your normal activities as quickly as possible.
Please note: it’s important to avoid smoking or taking anti-inflammatory painkillers as these can slow the healing process down.
When can I drive again?
The DVLA states that it’s the responsibility of the driver to ensure they are always in control of the vehicle. A good guide is when you can stamp down hard with the foot to stop the car during an emergency stop. How long this takes will vary, depending on how quickly you recover, but can be around six weeks after surgery.
Although Mr Heidari will advise you about when it’s safe to start driving again, it is your own responsibility to drive safely and you should also check with your vehicle insurer to confirm you are covered.
When can I return to work?
This varies, depending on the type of work you do and the speed of your recovery. In most cases, if you have a sedentary job (sitting down most of the time), you should be able to return after around two weeks. If your job involves manual work, you may need up to six weeks off.
What is the long term outcome of surgery?
In most cases, surgery is very successful at treating the pain and deformity associated with toe deformities. It can take up to two weeks for the wounds to heal while the healing of the bone can take up to six weeks. You should be able to return to most of your normal activities, including sport, around three months after surgery. It can, however, take up to a year for the swelling to disappear.
What are the risks of surgery?
- All surgery carries risks. With this type of surgery, risks include a small chance of infection which can be treated with antibiotics
- There is a small chance of deep vein thrombosis (DVT) following any surgery, although this is unusual following this type of surgery. However, you may be given blood-thinning medication after surgery as a precaution or if you are at higher risk. You will also be given support socks and exercises to reduce the chances of DVT
- There is also a small chance of nerve damage which can cause temporary or permanent numbness around the toe
- In some cases, the bones may not joint together correctly as they heal and, although this may not be painful, you may need to have further surgery
- The metal that’s used to fuse the joint can stick out. However, this can easily be removed later on, once the joint has healed
You can find more information about recovering from big toe fusion surgery in our patient information leaflet, which can be downloaded from this website.