What does the operation involve?

The operation can be performed either under general anaesthesia or regional anaesthesia. This decision can be made after discussion with the anaesthetist. The procedure involves making an incision over the affected area and removing the bony lumps, inspecting and cleaning the joint and releasing the soft tissue. Sometimes a cut is taken from the bone of the big toe (Moberg osteotomy), to aid in the recovery of movement after the operation.

What about pain?

You may be given a local anaesthetic nerve block to ensure immediate post-operative pain relief. Whilst you are in hospital you will be monitored and the medical staff will give you painkillers as required and prescribed. When you are at home you may find Paracetamol and/or anti-inflammatories useful for controlling any pain. Instructions on the management of pain will be given by the nursing staff before you leave the hospital.

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How long does recovery take?

Most patients who have Cheilectomy surgery will go home the same day or stay one night. The majority of patients have only a padded dressing and bandage to the wound. You will be given a special shoe, which helps to off load the forefoot. The physiotherapist will give instructions on how to wear the shoe as well as the use of elbow crutches if necessary. For the first two weeks you are advised to restrict your walking distance to within the house and garden and to elevate the foot as much as possible. Swelling is quite common after foot surgery and this is best managed by elevating the foot on a pillow every night and during the day on at least three different occasions e.g 11am, 3pm and 6pm for about one hour each time. This will help to reduce swelling of the foot and speed wound healing. Full weight bearing is commenced after about six weeks.

Your wound dressing will be changed at 7-14 days and the stitches removed or trimmed. You are advised to keep the dressing clean and dry until the stitches are removed. Once the bandages are removed it is advisable to wear loose fitting shoes (e.g. ECCO, Hotter or sports shoes). Normal footwear (which is well fitting) can be worn about three months after the operation.

People vary in how quickly the swelling disappears after surgery and three months is not at all unusual. Provided you are not having undue pain or inflammation there is probably nothing to worry about and you can afford to give it time.

Patients having had only the left foot operated on will be able to drive an automatic car within two weeks. Those who have had an operation on the right side will be able to drive after about 6-8 weeks. You are advised not to fly after surgery for about 6 weeks. Swimming will be possible once the sutures are removed and the wound is healing satisfactorily.

What are the possible complications?

  • Infection in the wound
  • Prolonged swelling (this can last 3 to 6 months)
  • Nerve injury
  • Transfer metatarsalgia (pain in the metatarsal bones of the foot)
  • Stiffness of the joint
  • Deep vein thrombosis (clot in the vein)
  • Pulmonary embolus (clot in the lung)
  • Recurrence of symptoms (there is a 25% failure rate)

The above complications are rare but can occur.